Epidemiology And Perspectives Of Stroke In The Elderly

Stroke in the elderly has more major differences compared to young people: 1) it is the first complication of atherothrombosis disease associated to the following risk factors: hypertension, diabetes, hypercholesterolemia, tobacco consumption, and sleep apnea syndrome; 2) it is the first consequence of atrial fibrillation; 3) on a clinical point of view, the pseudobulbar syndrome is very frequent and explains the swallowing troubles and incontinence; 4) prognosis is characterized by a high risk of dementia (20%), affecting the secondary prevention; 5) primary and secondary prevention is very effective even in very old patients, not only on the risk of stroke, but also on the risk of dementia; 6) time trends in Dijon show a slight decrease of incidence rates of stroke only over 85 years, whereas prevention of stroke has beneficiated of real progress in precocious diagnosis and innovative treatments. In contrast, we observed a decrease of case-fatality rates at any day and a delay in age of onset of stroke of five years in men and eight years in women, suggesting an increase of life expectancy without stroke, reflecting a certain efficacy of prevention.