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The role of age in intracerebral hemorrhages
Elvis Camacho1, Melissa A LoPresti1, Sam Bruce1
1Department of Neurological Surgery, Cerebrovascular Laboratory, Columbia University College of Physicians and Surgeons, 630 West 168th Street, New York, NY 10032, USA.
Insights
Age significantly impacts intracerebral hemorrhage (ICH) risk and outcomes. Common age cutoffs used in research range from 60-80 years, often centering on 65 or 70.
Area of Science:
- Neurology
- Gerontology
- Public Health
Background:
- Intracerebral hemorrhage (ICH) is a severe type of stroke and a leading cause of death.
- Age is a significant risk factor for ICH, influencing physiological changes and comorbidities.
- Existing literature shows varied age cutoffs (60-80 years) for increased ICH mortality and morbidity.
Purpose of the Study:
- To clarify the role of age in intracerebral hemorrhage (ICH).
- To identify and analyze common age cutoff points used in ICH literature.
- To inform treatment strategies and clinical trial design for aging populations.
Main Methods:
- Literature review of studies on intracerebral hemorrhage and age.
- Analysis of age-related risk factors, physiological changes, and comorbidities.
- Examination of reported age cutoffs for mortality and morbidity in ICH.
Main Results:
- Age is a critical determinant of ICH risk and outcomes.
- Commonly cited age cutoffs for increased ICH risk are 65 and 70 years.
- Age-related physiological changes and comorbidities like hypertension exacerbate ICH risk.
Conclusions:
- Age plays a complex role in intracerebral hemorrhage, affecting risk and outcomes.
- Standardized age cutoffs are lacking, necessitating further research.
- Understanding age's impact is crucial for tailored ICH treatment and clinical trials.
Abstract:
We aimed to identify the role of age in intracerebral hemorrhage (ICH), as well as characterize the most commonly used age cut off points in the literature, with the hope of understanding and guiding treatment. Strokes are one of the leading causes of death in the USA, and ICH is the deadliest type. Age is a strong risk factor, but it also affects the body in numerous ways, including changes to the cardiovascular and central nervous systems that interplay with the multiple risk factors for ICH. Understanding the role of age in risk and outcomes of ICH can guide treatment and future clinical trials. A current review of the literature suggests that the age cut offs for increased rates of mortality and morbidity vary from 60-80 years of age, with the most common age cut offs being at 65 or 70 years of age. In addition to age as a determinant of ICH outcomes, age has its own effects on the maturing body in terms of changes in physiology, while also increasing the risk of multiple chronic health conditions and comorbidities, including hypertension, diabetes, and anticoagulant treatment for atrial fibrillation, all of which contribute to the pathology of ICH. The interaction of these chronic conditions, changes in physiology, age, and ICH is evident. However, the exact mechanism and extent of the impacts remains unclear. The ambiguity of these connections may be further obscured by individual patient preferences, and there are limitations in the literature which guides the current recommendations for aging patients.
