Nationwide Trends in Incidence and Mortality of Stroke Among Younger and Older Adults in Denmark

Abstract

ObjectiveTo investigate the extent to which the incidence and mortality of a first-time stroke among younger and older adults changed from 2005 to 2018 in Denmark using nationwide registries.MethodsWe used the Danish Stroke Registry and the Danish National Patient Registry to identify patients 18 to 49 years of age (younger adults) and those ≥50 years of age (older adults) with a first-time ischemic stroke, intracerebral hemorrhage, or subarachnoid hemorrhage. We computed age-standardized incidence rates and 30-day and 1-year mortality risks separately for younger and older adults and according to smaller age groups, stroke subtype, sex, and severity (Scandinavian Stroke Scale score). Average annual percentage changes (AAPCs) were computed to assess temporal trends.ResultsWe identified 8,680 younger adults and 105,240 older adults with an ischemic stroke or intracerebral hemorrhage. The incidence rate per 100,000 person-years of ischemic stroke (20.8 in 2005 and 21.9 in 2018, AAPC −0.6 [95% confidence interval (CI) −1.5 to 0.3]) and intracerebral hemorrhage (2.2 in 2005 and 2.5 in 2018, AAPC 0.6 [95% CI −1.0 to 2.3]) remained steady in younger adults. In older adults, rates of ischemic stroke and intracerebral hemorrhage declined, particularly in those ≥70 years of age. Rates of subarachnoid hemorrhage declined, but more so in younger than older adults. Stroke mortality declined over time in both age groups, attributable largely to declines in the mortality after severe strokes. Most trends were similar for men and women.ConclusionThe incidence of ischemic stroke and intracerebral hemorrhage was steady in younger adults from 2005 to 2018, while it dropped in adults >70 years of age. Stroke mortality declined during this time.

Temporal trend of first-ever ischaemic stroke incidence from 2010 to 2019 in South Korea: a nationwide retrospective cohort study

“…This can be due to two reasons: first, the age of the population increased over the period of study,12 and second, because the risk factors for stroke were better managed 22. A decline in stroke incidence has also been observed in high-income countries,2 which is consistent with the findings of this study: age-standardised incidence rate of ischaemic stroke decreased from 1990 to 2014 in Scotland,23 decreased from 2003 to 2013 in Iran,4 decreased from 2005 to 2018 in Denmark,24 and showed a declining trend from 2003 to 2011, then increased until 2017 in Canada 25…”

Background rates of hospitalizations and emergency department visits for selected thromboembolic and coagulation disorders in Ontario, Canada, 2015 to 2020, to inform COVID-19 vaccine safety surveillance

“…24 . 25 Our crude rates of ischemic stroke and intracerebral haemorrhage during 2015-2017 were approximately 1.5 to 2 times the age-sex standardized rates during the same period in a previous study in Ontario. 26 However, that study included only the first-ever episode whereas we included episodes occurring after a 365-day period.…”

Patients Hospitalized for Ischemic Stroke and Intracerebral Hemorrhage in France: Time Trends (2008–2019), In-Hospital Outcomes, Age and Sex Differences

“…According to the Global Burden of Disease Study, a significant increase in stroke prevalence and incidence rates in terms of ischemic stroke (IS) was found in both men and women aged under 70 years between 1990 and 2019, with even faster increases observed from 2010 to 2019 [ 1 ]. A stable or increasing trend in stroke incidence among middle-aged people was recently observed in the USA, Canada, Australia, and European countries including France [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 ]. Several studies have predicted a substantial increase in the number of stroke cases in high-income countries by 2030 and 2050, associated with almost a doubling of healthcare costs related to stroke by then [ 1 , 11 , 12 , 13 ], as supported by projections from the Dijon Stroke Registry for France [ 14 ].…”