Trends in Survival and Recovery From Stroke and Compression of Morbidity

Abstract

See related article, pages 563–565. Substantial increases of life expectancy in developed countries are well documented, and further increases are anticipated in the 21st century.1 The question remains, however, whether this increased longevity can be achieved together with postponed functional limitation and disability or whether increasing life expectancy will yield greater disability.1 According to the Compression of Morbidity paradigm, “if the average age at first chronic infirmity is postponed, and if this postponement is greater than increases in life expectancy, then average cumulative lifetime morbidity will decrease, squeezed between a later onset and the time of death.”2 Although the biological foundation of compression of morbidity remains unknown, data from various clinical/epidemiological databases can be helpful in our understanding of short- and long-term trends for major diseases, including disease incidence, survival, and recovery. In developed countries, the number of people greater than age 65 is increasing. When people age, they become more susceptible to disease, and their risk of mortality dramatically increases. However, an explosion of recent advances in disease-modifying factors, including specific prevention strategies, treatments, and rehabilitation options, should lead to decreases in both disease incidence and mortality, resulting in positive trends in life extension and recovery rates. Worldwide, stroke remains 1 of the major causes of death and long-term disability. Stroke imposes substantial burden, both economic and social, on individuals, their families, and society.3 As with many other diseases, the incidence of stroke increases dramatically with age.4 The impact of stroke, and its challenge to health care systems, is expected to increase during the next decade, as the “baby boomers” enter older age. Fortunately, advances in early …