“Strokes can occur in anyone … at any age.”
Stroke prevention efforts are often focused on older adults. That’s because 60 percent of strokes happen in adults 65 years and older, according to the Centers for Disease Control and Prevention.
While it’s true that stroke risk increases as you age, that doesn’t give younger folks a free pass. More than 30 percent of stroke victims are younger than 65—and that’s not an insignificant number.
“The truth is that strokes can occur in anyone—at any age,” says Carolyn Brockington, MD, neurologist at Mount Sinai Hospital. “It is true that the incidence of stroke—meaning the number of strokes—increases as people get older, but it doesn’t mean you can’t have a stroke when you’re young.”
Although strokes among young adults are fewer in number, they are still a big concern. Strokes in young adults cause a greater economic impact by potentially disabling victims who are just starting or at the peak of their careers.
Plus, the lack of awareness of stroke symptoms among young adults makes them less likely to get prompt and life-saving stroke treatment. This puts them at a greater risk for worse outcomes and even loss of life, according to the National Stroke Association.
Why More Young People Are Having Strokes
On one hand, young adults and even children have always had strokes. However, strokes are becoming more common at a younger age. For example, one 2012 study from the University of Cincinnati College of Medicine found that the proportion of strokes among people under age 55 increased from 12.9 percent in 1994 to 18.6 percent in 2005.
“One of the biggest reasons is obesity in childhood,” says Dr. Brockington. “The diseases that we know are connected to stroke as you get older are now developing earlier.”
Conditions like high blood pressure, heart disease, and type 2 diabetes are becoming more common in young adults. Each of these conditions increases the risk of atherosclerosis—the hardening and clogging of blood vessels—which in turn can increase the risk of stroke.
“Let’s say you were obese as a teenager. Now you might develop high blood pressure, or hypertension, in your twenties,” says Dr. Brockington. “Now we’re seeing a shift in the incidence to younger strokes.”
Other Reasons Young Adults Have Strokes
Along with the “classic” types of stroke—hemorrhagic stroke and ischemic stroke—young adults and even children tend to have strokes for different reasons than older adults.
Blood-clotting problems: Seemingly healthy people might form blood clots excessively that put them at risk of stroke. One example is a woman taking oral contraceptives that caused blood clots to go to the brain, according to Dr. Brockington. (Not everyone will get blood clots from contraceptives. Learn more about the effect of birth control on blood clots here.)
Heart problems: “Sometimes people who are younger actually have a structural abnormality that might predispose them to stroke,” says Dr. Brockington. One example is patent foramen ovale, which is a small hole in the heart.
Blood vessel problems: Injuries to the artery may cause a narrowing similar to atherosclerosis. “It’s not that the artery is becoming narrow from plaque, but it’s becoming narrow because it was injured—either through activity or otherwise,” says Dr. Brockington.
Being able to recognize a stroke quickly is important at every stage of life, but unfortunately, the belief that stroke only happens to older adults puts young people at risk.
“Many times, people come in with signs and symptoms of stroke, but they’re told ‘Oh, it can’t be a stroke because you’re so young,’” says Dr. Brockington. “That’s crazy, because it can still be a stroke.”
If you recognize you’re not feeling well and you’re experiencing the sudden onset of stroke-like symptoms, it’s important to call an ambulance for immediate stroke treatment—regardless of your age or any other factor.
Dr. Brockington is a neurologist and director of the Stroke Center at Mount Sinai St. Luke’s and Mount Sinai West Hospital in New York City.
00:00:02,540 --> 00:00:05,800
The truth is the stroke's gonna
occur in anyone at any age.
00:00:05,800 --> 00:00:08,160
It just has to do with
interruption of blood flow.
00:00:08,160 --> 00:00:10,140
So it is true that
the incidence of stroke,
00:00:10,140 --> 00:00:12,800
meaning the number of strokes
increases people that older.
00:00:12,800 --> 00:00:18,544
But it doesn't mean that you can't
have a stroke when you're young.
00:00:18,544 --> 00:00:19,746
00:00:19,746 --> 00:00:23,162
And I think one of the biggest
reasons is obesity in childhood.
00:00:23,162 --> 00:00:26,910
The diseases that we know that
are connected with stroke as you get older
00:00:26,910 --> 00:00:28,620
are now developing earlier.
00:00:28,620 --> 00:00:31,560
So le's say you were obese as a teenager,
00:00:31,560 --> 00:00:35,110
now you might develop the high blood
pressure or hypertension in your 20s or
00:00:35,110 --> 00:00:38,900
diabetes, etc., and all those things
are associated with stroke, so
00:00:38,900 --> 00:00:42,980
now we're seeing a shift in
the incidents to youngers drugs.
00:00:42,980 --> 00:00:46,960
Part of the problem is people don't really
understand what the symptoms are, but
00:00:46,960 --> 00:00:49,670
it's also recognizing it and
thinking, can it happen to me?
00:00:49,670 --> 00:00:52,020
But if you think you're young,
how could I have a stroke?
00:00:52,020 --> 00:00:56,824
So you kinda discard it, but there's
a lot of denial in stroke that I think
00:00:56,824 --> 00:01:01,877
a lot of awareness as well as education,
we'll begin to sort of chip away at.
00:01:01,877 --> 00:01:05,027
There are different things and
different reasons why younger people might
00:01:05,027 --> 00:01:08,210
have stroke, and we look at all
those things when someone comes in.
00:01:08,210 --> 00:01:10,830
Number one, we're looking for
00:01:10,830 --> 00:01:14,000
Maybe it's a woman who was
on an oral contraceptive and
00:01:14,000 --> 00:01:15,850
developed blood clots and
went to the brain.
00:01:15,850 --> 00:01:17,200
Two is the heart.
00:01:17,200 --> 00:01:21,921
Sometimes people who are younger actually
have a structural abnormality that might
00:01:21,921 --> 00:01:25,844
predispose them to stroke,
we call that patent foramen ovale, PFO,
00:01:25,844 --> 00:01:28,188
where they have a small hole in the heart.
00:01:28,188 --> 00:01:32,329
And then, three, blood vessels, sometimes
when you're younger you might actually
00:01:32,329 --> 00:01:36,299
injure the artery so it's not that the
artery's becoming narrowed from plaque but
00:01:36,299 --> 00:01:39,758
it's becoming narrow because it was
injured either through activity or
00:01:39,758 --> 00:01:40,400
00:01:40,400 --> 00:01:43,480
Many times, people come in with signs and
symptoms of stroke, but
00:01:43,480 --> 00:01:45,930
it can't be a stroke cuz you're so young.
00:01:45,930 --> 00:01:48,470
And that's crazy,
because it can still be a stroke.
00:01:48,470 --> 00:01:52,270
So I think the important thing is for
anybody to realize if suddenly they feel
00:01:52,270 --> 00:01:55,970
that they're not feeling well, and
the symptoms are sudden in the way we
00:01:55,970 --> 00:02:00,240
describe, sudden weakness on one side of
the body, numbness, problems with vision,
00:02:00,240 --> 00:02:03,630
problems with speech, that they really
should go to the hospital right away.
00:02:03,630 --> 00:02:06,591
And if they don't get the appropriate
treatment, continue to push forward.
00:02:06,591 --> 00:02:11,839
Hankey GJ. Stroke in young adults: implications of the long-term prognosis. JAMA. 2013;309(11):1171-2.
Ischemic stroke in children and young adults: etiology and clinical features. Waltham, MA: UpToDate, 2021. (Accessed on April 26, 2021 at https://www.uptodate.com/contents/ischemic-stroke-in-children-and-young-adults-etiology-and-clinical-features#H4.)
Kissela BM, Khoury JC, Alwell K, Moomaw CJ, Woo D, Adeoye O, et al. Age at stroke: temporal trends in stroke incidence in a large, biracial population. Neurology. 2012 Oct 23;79(17):1781-7.
Smajlovic D. Strokes in young adults: epidemiology and prevention. Vasc Health Risk Manag. 2015;11:157-164.
Stroke facts. Atlanta, GA: Centers for Disease Control and Prevention, 2017. (Accessed on April 26, 2021 at https://www.cdc.gov/stroke/facts.htm.)Young stroke survivors. Centennial, CO: National Stroke Association. (Accessed on August 7, 2018 at http://www.stroke.org/understand-stroke/impact-stroke/young-stroke-survivors.)