Stroke in the elderly – abnormalities
Journal Title: Postępy Nauk Medycznych - Year 2010, Vol 23, Issue 4
Abstract
Consistent ageing of the society leads to higher stroke incidence. Within next 20 years stroke incidence is expected to increase by 40%. Most of strokes will occur in the elderly population. Apart from age, the most important stroke risk factor, substantial impact on stroke incidence have widespread of hypertension, diabetes and obesity. Increase stroke incidence in elderly is also caused by increase frequency of cardiovascular changes.The proportion of hospitalised strokes decrease with age and stroke of unknown etiology is more often diagnosed in elderly patients. Out of ischemic strokes of known etiology more common are strokes of cardioembolic etiology due to atrial fibrillation and watershield infarction due to hypotension.Different course of stroke in the elderly is determined by poorer cardiovascular response, multiple organ dysfunction, multiple medications consumption and presence of other neurological conditions. In the end the course of stroke is more severe, there are more complications and more adverse events connected to pharmacotherapy. Moreover there are more complications due to bedridden state. Early mortality in the stroke patients over 85 years old is twofold bigger as in younger patients. Additionally functional state is significantly worse in the elderly patients after stroke and institutional care is more often needed.Inability of routine intravenous thrombolysis in patients over 80 years old is the most important difference in acute stroke management in the elderly patients. Furthermore prophylactic treatment of stroke recurrence is more difficult due to coexisting diseases and more frequent adverse events after pharmacotherapy.
Authors and Affiliations
Maciej Świat
Keywords
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