Is stroke no longer a disease of older people?

There are rising cases of brain stroke in young people. As we celebrate World Stroke Day every year on the 29 of October, stroke remains the most important cause of mortality and morbidity in our country. Not only the patient but a stroke affects the entire family both financially and emotionally.

Usually, stroke was considered the disease of older people, and the younger population was still unaffected by it. This trend has changed in recent times, and every 1 out of 10 stroke patients we come across is in the 4th or even 3rd decade of life.

India is considered a country where the young population surpasses older people. This trend is alarming as it has a solid economic burden that leaves patients disabled before their most
productive years.

The prevalence of traditional risk factors of stroke, which include Hypertension, diabetes, hypercholesterolemia, and central obesity, is different in young than in adults. The change in habits such as alcohol consumption, smoking, consumption of tobacco and products, illicit drugs, and sedentary lifestyle has contributed to the rise in the incidence of stroke amongst
the young. 

Modifiable risk factors also do contribute to a stroke, which includes genetic and heredity causes leading to etiologies like vasculitis, dissection, Moya disease, Fabry disease, and cardioembolic stroke due to PFO. Identifying symptoms and timely treatment of stroke is paramount in the management in treatment of stroke. 

Many people are asymptomatic and often ignorant about subtle signs and symptoms because of the previous notion and understanding that stroke is a disease of older people. Not only this, but a lot of patients are also diagnosed with diabetes or Hypertension for the first time at the onset of stroke. There should be awareness about the symptoms, such as visual blurring, difficulty in speech, weakness in the arm or legs, and facial deviation. The patient should not waste time responding and getting treated for the same. 

The golden period after the onset of stroke is 4.5 hours. If a patient reaches the hospital facility can be given the benefit of thrombolysis, which in turn helps open the blocked vessels. 

Apart from medicine, stroke treatment and care involve a holistic approach, which includes judicious physiotherapy, occupational therapy, and mobilization. 

Prevention is the primary treatment strategy aimed at reducing the morbidity and mortality related to stroke, and adequate treatment, control of risk factors, and lifestyle changes can prevent up to 50% of strokes. 

Primary prevention aims to reduce the risk of stroke in asymptomatic subjects. It is focused on identifying and managing known vascular risk factors, such as arterial Hypertension, disorders of lipid metabolism, and diabetes mellitus, and non-drug strategies and lifestyle changes, including quitting smoking, limiting alcohol consumption, reducing elevated body weight, increasing regular aerobic physical activity, and adopting a healthy diet with more fruit and vegetables and less salt. 

We can reduce the burden of stroke by following this simple 4-step strategy: Prevention, Acute care, cure, rehabilitation, and restoration of living.