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Etiological Subclassification of Stroke in Older People ≥80 Years Compared to Younger People: A Systematic Review and Meta-Analysis
Örebro University, School of Medical Sciences. Department of Neurology and Rehabilitation, Central Hospital Karlstad, Karlstad, Sweden.ORCID iD: 0009-0007-4588-5227
Örebro University, School of Medical Sciences. Department of Neurology, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden.ORCID iD: 0000-0002-6681-0546
Örebro University, School of Medical Sciences. Department of Neurology, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden.ORCID iD: 0000-0002-3845-8100
Division of Medicine, Department of Neurology, Akershus University Hospital, Lørenskog, Norway.
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2024 (English)In: Journal of Geriatric Psychiatry and Neurology, ISSN 0891-9887, E-ISSN 1552-5708, Vol. 37, no 6, p. 436-447Article, review/survey (Refereed) Published
Abstract [en]

BACKGROUND: Due to the rapid growth of the world´s oldest population, the number of older persons with stroke is expected to rise. Knowledge of stroke etiology is essential to offer personalized and equal health care across age groups. The present systematic review aimed to investigate the prevalence of etiological subtypes of ischemic and hemorrhagic stroke in older compared to younger people.

METHODS: MEDLINE, Embase, Cochrane, Epistemonikos, and Cinahl were systematically searched for studies regarding etiological classification in people ≥80 years compared to those <80 years with ischemic or hemorrhagic stroke.

RESULTS: Out of 28 441 identified articles, eight met the inclusion criteria. In total, 8223 individuals were included in meta-analyses, of whom 2997 were 80 years or older. We demonstrated a higher prevalence of cardioembolic stroke in people ≥80 years OR 1.68 (95% CI, 1.12-2.53). Small vessel disease was significantly less common in older people OR .64 (95% CI, .50-.81). Regarding large vessel disease, no statistically significant difference between the two groups was shown OR 1.05 (95% CI, .77-1.43).

CONCLUSION: In people ≥80 years, cardioembolic stroke is more common, and small vessel disease less common compared to people <80 years. Overall, the results have to be interpreted with caution due to few studies. Large studies using validated classification systems are needed.

Place, publisher, year, edition, pages
Sage Publications, 2024. Vol. 37, no 6, p. 436-447
Keywords [en]
Etiological classification, hemorrhagic stroke, ischemic stroke, meta-analysis, people ≥ 80 years, systematic review
National Category
Neurology
Identifiers
URN: urn:nbn:se:oru:diva-113754DOI: 10.1177/08919887241254466ISI: 001226517100001PubMedID: 38761091Scopus ID: 2-s2.0-85193500714OAI: oai:DiVA.org:oru-113754DiVA, id: diva2:1859687
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Örebro UniversityRegion VärmlandAvailable from: 2024-05-22 Created: 2024-05-22 Last updated: 2024-10-01Bibliographically approved

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Sanner, JohanStröm, Jakob O.von Euler, MiaFure, Brynjar

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