Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jul 15;2(3):24.
doi: 10.3390/geriatrics2030024.

Stroke in Frail Older People

David G Smithard  1   2
Affiliations

Stroke in Frail Older People

David G Smithard. Geriatrics (Basel). .

Abstract

The population is ageing, with the greatest proportional increase in those >80 years of age. Many of these people will be frail and at risk of stroke. Research has shown that the very old have much to benefit from hyperacute stroke intervention, but at the same time they suffer increased mortality. Their outcome following stroke and intervention is more often predicted by the presence of frailty rather than age alone. Intervention both in primary prevention and hyperacute stroke management needs to allow for preexisting morbidity and frailty in deciding what is and what is not appropriate, rather than an arbitrary decision on age. Frail older people are more likely to develop delirium and dysphagia combined with poor mouthcare and die, yet all of these issues are managed badly. An increased awareness of these complications of stroke in the frail older person is necessary.

Keywords: acute; complications; ethics; frailty; old age; stroke.

PubMed Disclaimer

Conflict of interest statement

The author declares no conflict of interest.

Figures

Figure 1
Figure 1
Changing age distribution, from the United Nations Population Division No 2012/4 December 2012. www.UNpopulation.org.
Figure 2
Figure 2
Schematic representation of risk vs. benefit in hyperacute stroke treatment in frail older adults.
Figure 3
Figure 3
The interplay between age, frailty, comorbidity and stroke on outcome.
See this image and copyright information in PMC

References

    1. Suzman R., Beard J. Global Health and Aging National Institute on Aging National Institutes of Health, U.S. Department of Health and Human Services. World Health Organization (WHO); Geneva, Switzerland: 2011.
    1. Truelsen T., Piechowski-Jozwiak B., Bonita R., Bogousslavsky J., Boysen G. Stroke incidence and prevalence in Europe: A review of available data. Eur. Neurol. 2006;13:581–598. doi: 10.1111/j.1468-1331.2006.01138.x. - DOI - PubMed
    1. Breen L., Phillips S.M. Skeletal muscle protein metabolism in the elderly: Interventions to counteract the “anabolic resistance” of ageing. Nutr. Metab. 2011;8:68–79. doi: 10.1186/1743-7075-8-68. - DOI - PMC - PubMed
    1. Mateen F.J., Buchan A.M., Hill M.D. Outcomes of thrombolysis for acute ischemic stroke in octogenarians versus nonagenarians. Stroke. 2010;41:1833–1835. doi: 10.1161/STROKEAHA.110.586438. - DOI - PubMed
    1. Gilleard C., Higgs P. Third age and baby boomers. Int. J. Ageing Later Life. 2007;2:13–30. doi: 10.3384/ijal.1652-8670.072213. - DOI

LinkOut - more resources