Age at the time of stroke in patients with mental disorders

Patients with mental disorders have a higher risk of stroke and stroke-related mortality. Whether mental disorders are associated with stroke at an earlier age remains unclear.

We conducted a population-based study using the Spanish National Health System Hospital Discharge Records (RAE-CMBD; 2019-2023), including all patients with a diagnosis of ischaemic or haemorrhagic stroke admitted to public hospitals in Spain. Age at stroke was compared between patients with and without mental health conditions diagnosed prior to stroke (depression, anxiety, schizophrenia, bipolar disorder, or personality disorder), using multivariate linear regression models.

A total of 311,528 stroke patients were included (239,518 ischaemic; 72,010 haemorrhagic). Among ischaemic stroke patients, mean age at onset was 74.8 years (SD 13.6). Age at ischaemic stroke was significantly younger for those with personality disorder (63.9 vs. 74.8 years; p < 0.001), schizophrenia (67.3 vs. 74.8 years; p < 0.001), bipolar disorder (70.3 vs. 74.8 years; p < 0.001), and anxiety disorder (73.2 vs. 74.8 years; p < 0.001). Age at haemorrhagic stroke was also significantly younger for those with personality disorder (60.1 vs. 69.1 years; p < 0.001) and schizophrenia (64.2 vs. 69.1 years; p < 0.001).

Among patients with stroke, those with personality disorder, schizophrenia, or bipolar disorder had significantly younger ages at stroke than those without these diagnoses, independent of conventional vascular risk factors.