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    Stroke risk and mortality significantly increase in individuals aged 80 and older. Despite potential benefits from stroke unit care and early treatments, the very elderly are often excluded from urgent stroke management.

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    Area of Science:

    • Geriatric Medicine
    • Neurology
    • Public Health

    Context:

    • Stroke incidence rises with age, disproportionately affecting the very elderly (>= 80 years).
    • This demographic accounts for a significant majority of stroke-related morbidity and mortality.
    • Stroke presentation and outcomes in the very elderly differ markedly from younger populations.

    Purpose:

    • To highlight the unique characteristics of stroke in the very elderly.
    • To underscore the underrepresentation of this population in critical stroke care.
    • To emphasize the need for inclusive management strategies.

    Summary:

    • The very elderly experience a higher burden of stroke, with distinct risk factors like atrial fibrillation and hypertension, and a greater likelihood of poor functional outcomes.
    • Despite evidence suggesting benefit from stroke unit care and early revascularization, these treatments have historically excluded the very elderly.
    • This disparity in care is a growing concern given global population aging.

    Impact:

    • Improved understanding of stroke in aging populations.
    • Advocacy for equitable access to advanced stroke treatments for the very elderly.
    • Informing public health policies to address the escalating impact of stroke on aging societies.