Department of Neurology and Cerebrovascular Medicine, Saitama International Medical Center, Saitama Medical University, Saitama, Japan.
Department of Neurology and Cerebrovascular Medicine, Saitama International Medical Center, Saitama Medical University, Saitama, Japan.
J Stroke Cerebrovasc Dis. 2015 Apr;24(4):811-4. doi: 10.1016/j.jstrokecerebrovasdis.2014.11.019. Epub 2015 Feb 11.
Japan has the fastest aging society in the world. Older patients have a different stroke risk profile and different stroke features compared with younger patients. The aim of the present study was to examine the stroke subtypes, risk factor profiles, stroke severities, and functional outcomes in the different age groups.
A total of 78,096 patients with acute ischemic stroke, including transient ischemic attacks, were included in a multicenter, hospital-based registration study based on a computerized database involving 95 Japanese institutes between 2000 and 2012.
The frequency of atrial fibrillation increased even after the age of 90 years; consequently, the proportion of patients experiencing cardioembolic stroke also increased in the same age group. Furthermore, more severe symptoms on arrival and worse functional outcomes were observed with increasing age. The frequency of hypertension increased with age, peaking in patients in their 70s, and decreasing slightly thereafter. The frequency of diabetes mellitus and hyperlipidemia peaked in patients in their 50s or 60s and gradually decreased thereafter.
The findings of the present study suggest that in the currently aging society, cardioembolic stroke is the most important stroke subtype. The roles of hypertension, diabetes mellitus, and hyperlipidemia are greatest in stroke patients in their 50s to 60s. In older patients, the role of atrial fibrillation is more significant.
日本是世界上老龄化速度最快的国家。与年轻患者相比，老年患者的卒中风险谱和卒中特征不同。本研究旨在探讨不同年龄组患者的卒中亚型、危险因素谱、卒中严重程度和功能结局。
本研究共纳入了 2000 年至 2012 年间，95 家日本医院基于计算机数据库开展的一项多中心、以医院为基础的登记研究中的 78096 例急性缺血性卒中（包括短暂性脑缺血发作）患者。
即使在 90 岁以上的年龄组，心房颤动的频率也在增加；因此，心源性栓塞性卒中的患者比例在同一年龄组也有所增加。此外，随着年龄的增加，患者入院时的症状更严重，功能结局更差。高血压的频率随年龄增加而增加，在 70 多岁的患者中达到峰值，此后略有下降。糖尿病和高脂血症的频率在 50 多岁或 60 多岁的患者中达到峰值，此后逐渐下降。
本研究结果表明，在当前老龄化社会中，心源性栓塞性卒中是最重要的卒中亚型。高血压、糖尿病和高脂血症在 50 多岁至 60 多岁的卒中患者中发挥着最大作用。在老年患者中，心房颤动的作用更为显著。
