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Stroke trends in an aging population. The Technology Assessment Methods Project Team
L W Niessen1, J J Barendregt, L Bonneux
1Department of Public Health and Social Medicine, Erasmus University, Rotterdam, The Netherlands.
Stroke
|July 1, 1993
Summary
Stroke incidence is declining, but increased survival is raising prevalence in older adults. This trend impacts overall stroke burden despite fewer acute episodes.
Area of Science:
- Neurology
- Epidemiology
- Public Health
Background:
- Stroke incidence and survival trends significantly influence morbidity and mortality.
- Understanding these trends is crucial for public health planning.
Purpose of the Study:
- To quantify stroke incidence decline and survival improvements in the Netherlands (1979-1989).
- To project future stroke morbidity changes (1985-2005) considering population aging.
Main Methods:
- Utilized a state-event transition model integrating Dutch population projections and stroke epidemiology data.
- Analyzed national age- and sex-specific hospital admission and mortality rates for stroke.
- Extrapolated historical trends to project future stroke morbidity rates.
Main Results:
- Observed a consistent annual incidence decline: -1.9% for men and -2.4% for women.
- Projected a 35% decrease in stroke incidence rate over 20 years, assuming constant mortality decline.
- Despite an overall decrease in acute stroke episodes, major stroke prevalence is projected to increase in the oldest age groups due to improved survival.
Conclusions:
- The observed mortality decline is attributed to both incidence decline and increased survival.
- Population aging partially counteracts the benefits of incidence decline on the total stroke burden.
- Enhanced cardiovascular survival contributes to a higher prevalence of major stroke among the elderly.