Abstract
Stroke has a greater effect on the elderly than on younger patients. However, the long-term outcomes associated with stroke among elderly patients with diabetes are unknown. We aimed to assess the differences in long-term outcomes between young and elderly stroke patients with diabetes. A total of 3,615 acute ischemic stroke patients with diabetes were recruited for this study between 2006 and 2014. Outcomes at 12 and 36 months after stroke (including mortality, recurrence, and dependency) were compared between younger (age <75 years) and elderly (age ≥75 years) patients. The elderly group included 692 patients (19.1%) overall. Elderly patients were more likely than younger patients to have a Trial of Org 10172 in Acute Stroke Treatment classification of stroke due to cardioembolism, moderate and severe stroke, and atrial fibrillation, but less likely to have hypertension and dyslipidemia, current smokers, and alcohol consumers. Mortality, dependency, and recurrence rates at 12 months after stroke were 19.0, 48.5, and 20.9% in the elderly group and 7.4, 30.9, and 15.4% in the younger group, respectively (all P < 0.05). Corresponding rates at 36 months after stroke were 35.4, 78.7, and 53.8% in the elderly group and 13.7, 61.7, and 43.0% in the younger group, respectively (all P < 0.001). The mortality, dependency, and recurrence rates at 12 and 36 months after stroke were significantly higher in the elderly group than in the younger group after adjusting for stroke subtypes, stroke severity, and risk factors. Odds ratios (95% confidence interval) at 12 and 36 months after stroke were 2.18 (1.64–2.89) and 3.10 (2.35–4.08), respectively, for mortality, all P < 0.001; 1.81 (1.49–2.20) and 2.04 (1.57–2.34), respectively, for dependency, all P < 0.001; and 1.37 (1.06–1.76) and 1.40 (1.07–1.85), respectively, for recurrence, P = 0.016. The findings from this study suggest that management and secondary prevention should be emphasized in elderly patients with diabetes in China to reduce mortality, recurrence, and dependency after stroke.
Highlights
Age is the most important non-modifiable risk factor for all subtypes of stroke, ischemic stroke (MONICA Project (Monitoring Trends Determinants in Cardiovascular Disease), 1988; Feigin et al, 2014)
This study found that mortality, dependency, and recurrence rates were significantly higher in the elderly group than in the younger group among stroke patients with diabetes mellitus (DM) at both 12 and 36 months
Age was a predictor of poor long-term outcomes among stroke patients with DM, it was independent of the benefit from treatment using antidiabetic
Summary
Age is the most important non-modifiable risk factor for all subtypes of stroke, ischemic stroke (MONICA Project (Monitoring Trends Determinants in Cardiovascular Disease), 1988; Feigin et al, 2014). The incidence of stroke more than doubles in each successive decade after the age of 55 years (MONICA Project (Monitoring Trends Determinants in Cardiovascular Disease), 1988). The age-standardized stroke incidence in low- and middle-income countries exceeds that in high-income countries by 21% in individuals ≥75 years old, and age-standardized stroke mortality exceeds that in high-income countries by 33%. Population-based studies have indicated that 65% of all strokes occur in individuals >65 years old (MONICA Project (MONICA Project (Monitoring Trends Determinants in Cardiovascular Disease), 1988; Lloyd-Jones et al, 2009). A populationbased study demonstrated that the incidence of first-ever stroke increased by 4.3% annually in China among those ≥65 years old from 1992 to 2012 (Wang et al, 2015)
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
