Elderly stroke burden: a comprehensive global study over three decades

Area of Science:

• Gerontology
• Epidemiology
• Public Health

Background:

• Stroke represents a significant global health challenge, impacting elderly patients' quality of life.
• The Global Burden of Disease (GBD) study provides critical data for understanding disease prevalence and impact.

Purpose of the Study:

• To analyze the trends in stroke burden among the elderly population worldwide from 1990 to 2021.
• To assess changes in stroke incidence, mortality, and disability-adjusted life years (DALYs) in older adults.

Main Methods:

• Utilized cross-sectional data from the Global Burden of Disease (GBD) 2021 study.
• Analyzed morbidity, mortality (all-cause and cause-specific), and DALYs for stroke in the elderly across 204 countries and territories.
• Calculated estimated annual percentage changes (EAPCs) to determine trend rates.

Main Results:

• Global stroke cases in the elderly increased from 4.39 to 8.19 million (1990-2021).
• Age-standardized incidence (ASIR) and mortality rates (ASMR) decreased significantly, with EAPCs of -0.784 and -1.446, respectively.
• Disability-adjusted life years (DALYs) increased, while the age-standardized DALYs rate (ASDR) declined. Stroke burden was higher in men than women across five Socio-Demographic Index (SDI) regions.

Conclusions:

• The overall number of stroke cases, deaths, and DALYs has risen in the elderly population.
• Despite increasing case counts, global age-standardized stroke incidence and mortality rates have declined.
• Older men face a disproportionately higher burden of stroke compared to older women.