Strokes on rise among young people
'Simply not true' that this medical emergency hits only older people
It's time to bust the dangerous myth that only elderly people have strokes, medical experts say.
"There's a public perception that stroke only affects people who are older and that's simply not true," Dr. Michael Hill, director of the Stroke Unit for the Calgary Stroke Program at Alberta Health Services, told CBC News.
"As a practising neurologist I see a fair number of young people with strokes, so it's not out of the ordinary."
While the majority of strokes strike people over 65, 10 to 15 per cent affect individuals 45 and younger — and that number is on the rise.
- Long work hours may raise stroke risk
- Strokes difficult to recognize, even for doctors
- Stroke success in Canada could be strained
According to the Heart and Stroke Foundation of Canada's 2014 annual report, strokes in people in their 50s have increased 24 per cent over the last decade.
A global analysis published in the Lancet in 2013 found the incidence of stroke in people aged 20 to 64 jumped by a quarter between 1990 and 2010, and those patients make up almost one-third of the total number of strokes.
The Lancet study also predicted stroke rates in that age group could double by 2030 — something Patrice Lindsay, director of best practices and performances at the Heart and Stroke Foundation, called "terrifyingly scary."
It's a different world
"The world we live in now is different than it used to be. People in our age group are working hard, they work much longer hours. There's an incredibly stressed work environment where people perceive that you have to work all these extra hours to get ahead and be successful," said Lindsay, a registered nurse who suffered a stroke at 38.
"All of that leads them to not eating properly, picking up a lot of fast food, picking up dinner on the way home late at night, not exercising on a regular basis."
While some of the risk factors for stroke, like smoking, have declined, others, like obesity, high blood pressure and diabetes, are on the rise among younger people.
However, Hill noted that some of the rise in stroke rates can likely be attributed to improvements in diagnostic technology.
Missing the signs
Because people associate strokes with the elderly, symptoms in younger victims can often be missed or dismissed — even by medical professionals.
A 2009 study by the Department of Neurology and Stroke Program at Wayne State University/Detroit Medical Center found that among 57 young stroke victims, one in seven were given a misdiagnosis of vertigo, migraine, alcohol intoxication, seizure, inner ear disorder or other problems — and sent home without proper treatment.
"Physicians are also susceptible to the same cognitive bias that I'm talking about in the general public, which is that they don't naturally expect stroke to be occurring in someone who's 25, for example. However, they should, because stroke is still the most common neurological event which would occur to a 25-year-old," Hill said.
While strokes are usually sudden, about 25 to 30 per cent of stroke victims report having experienced warning signs on and off in the hours or days before.
"If you have sudden neurological symptoms, they have to be taken seriously," Hill said.
The morning before Sidharth Gupta, then 30, suffered a massive stroke on Feb. 21, 2013, that has left him severely debilitated and unable to communicate, he texted a friend, saying food kept falling out of his mouth while he was trying to eat breakfast. He blamed it on a hangover.
Later in the day, he went to a walk-in clinic with numbness in his right arm and was told it was probably just a muscle strain.
It was only after he was found unconscious on the bathroom floor of a nightclub and taken to the emergency room at 3 a.m., that doctors performed a CT scan and realized he'd suffered a massive stroke that would change his life forever.
'If it walks like a duck'
The Heart and Stroke Foundation uses the FAST approach to recognizing stroke:
- Face: Is it drooping?
- Arms: Can you raise both?
- Speech: Is it slurred or jumbled?
- Time: To call 911 right away
The faster a person is treated, the better the chance of a good outcome. Once a stroke begins, 1.9 million brain cells die every minute.
Lindsay said it's important that people — especially health-care professionals — not dismiss FAST symptoms in young patients, even children.
"We're working hard to say if it walks like a duck, acts like a duck and talks like a duck, it's probably a duck. Doesn't matter the age of the patient. If they have the FAST signs, whether they resolved or not, it was probably a stroke."