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Stroke Rate May Be Declining In Older Adults

Stroke is the fourth highest cause of death among adults in the U.S. But among people older than 65, stroke rates may be going down, a study published Tuesday suggests. And compared with 10 or 20 years ago, more of those hit with a stroke are surviving.

In 1987, researchers from several universities recruited a group of 14,300 healthy adults who were above the age of 45, then kept track of their medical progress for 24 years. To see whether stroke rates were increasing or decreasing, the scientists compared people within the same age groups. For example, they compared adults who were between the ages of 65 and 69 in 1993 to men and women in that age range in 2003.

By 2011, the incidence of stroke among people over 65 had decreased by about 50 percent. In younger age groups, that rate stayed stable — but stroke-related deaths in this group went down. "The decreases varied across age groups," the scientists report, "but were similar across sex and race."

The results were published Tuesday in the Journal of the American Medical Association.

So should we be celebrating?

Not quite yet, says Dr. Joe Coresh, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health, and one of the authors of the study. "We should feel good that we're making progress," he tells Shots. "But we shouldn't be completely reassured."

These events, which have come to be called "brain attacks," happen when a blood vessel feeding the brain bursts or is blocked. And a number of factors — including smoking, obesity, high blood pressure and high cholesterol — can increase the risk.

Strokes have likely declined because we're getting better at addressing these risk factors, Coresh says. More people these days take medications for high cholesterol and hypertension. And more people are making the decision to quit smoking — or never start.

The scientists can't say for sure why more people are surviving a stroke, Coresh says. But it may be because doctors have gotten better at quickly getting them effective treatment.

Still, doctors and policymakers can and should be doing more to address this public health issue, Coresh says. Diabetes — another big risk factor for stroke — is on the rise, he notes. And questions still remain as to why stroke rates went down among those over 65, but not among younger adults.

"We know a lot about how to prevent stroke," he says. "And we should continue to be diligent about prevention."

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