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. 2018 Oct;28(10):686-690.e2.
doi: 10.1016/j.annepidem.2018.07.010. Epub 2018 Jul 24.

Temporal trends in age at ischemic stroke onset by ethnicity

Chengwei Li  1 , Jonggyu Baek  2 , Brisa N Sanchez  2 , Lewis B Morgenstern  3 , Lynda D Lisabeth  4
Affiliations

Temporal trends in age at ischemic stroke onset by ethnicity

Chengwei Li et al. Ann Epidemiol. 2018 Oct.

Abstract

Purpose: To explore temporal trends in age at first-ever ischemic stroke onset in a bi-ethnic, population-based study.

Methods: Cases of first-ever ischemic stroke (n = 3252) were identified in the Brain Attack Surveillance in Corpus Christi Project (2000-2012). Demographics and risk factors were abstracted from medical records. Trends in age at stroke onset were assessed overall and by ethnicity (Mexican American [MA] and non-Hispanic white [NHW]) using generalized additive models. Differences by ethnicity were tested by including an interaction term between time and ethnicity. Models were run unadjusted and adjusted for age of the population at risk for stroke.

Results: Mean age at first-ever ischemic stroke significantly decreased from an average of 71.7 years in 2000 to an average of 69.3 years in 2012 (p = .0043). Ethnicity significantly modified the temporal trends (p < .001) with declines greater in NHWs than in MAs; mean age was estimated to decrease from 74.8 to 71.3 over the 13 years for NHWs, whereas for MAs, mean age was estimated to decrease from 68.9 to 66.9 after adjusting for ethnic-specific average age of the population at risk.

Conclusions: Average age at first-ever stroke onset declined over time in this community. Efforts should be made to prevent stroke by controlling risk factors before and during midlife.

Keywords: Age; Ethnicity; Ischemic stroke; Trends.

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Figures

Figure 1.
Figure 1.
Temporal trends in age at stroke from validated cases of first-ever acute ischemic stroke in BASIC between January 1, 2000 and June 30, 2012. (A) Crude estimated/observed age at stroke. (B) Adjusted estimated/observed age at stroke. Dots indicate observed mean age each year. Black line indicates estimates from a generalized additive model (GAM) with smoothed time as the only predictor. Dashed lines indicate 95% confidence intervals (CI).
Figure 2.
Figure 2.
Temporal trends in age at stroke by ethnicity from validated cases of first-ever acute ischemic stroke in BASIC between January 1, 2000 and June 30, 2012. (A) Crude estimated age at stroke. (B) Adjusted estimated age at stroke. Estimates were from a GAM with smoothed time, ethnicity and the interaction term between time and ethnicity as predictors. Grey lines indicate estimates and 95% confidence intervals (CI) for Mexican Americans. Black lines indicate estimates and 95% CI for non-Hispanic whites.
See this image and copyright information in PMC

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