Treatment of stroke in older patients. A state of the art review.

The treatment of stroke in older patients is the rule rather than the exception in most parts of the world. Thus, an understanding of the effects of aging on pharmacological aspects of treatment, recovery and rehabilitation is very important. A considerable amount of work has now been completed looking for therapeutic interventions that might ameliorate the effects of stroke disease. Sadly, none has yet proved to be effective, but much is still awaited. In contrast, recent work has clarified the place of treatment in stroke prevention, particularly in hypertension and atrial fibrillation, which should help reduce the burden of stroke disease. In addition, it is now clear that well organised stroke care can dramatically reduce mortality and disability. The state of art in stroke treatment is now encapsulated in the multidisciplinary stroke unit and well coordinated hospital and community care.