Identification of prognostic factors associated with contemporary lifestyles in community-dwelling young stroke survivors

Background Over the past few decades, the global incidence of stroke among young adults (aged 18–50 years) has risen significantly. Given their prolonged post-stroke life expectancy, this trend has resulted in a substantial burden of long-term disability. Beyond traditional vascular prognostic factors, unhealthy modern lifestyles are increasingly contributing to this trend. Method This study enrolled community-dwelling adults from three communities in Guangzhou, who were stratified into a young adult group (aged 18–49 years) and an older adult group (aged ≥50 years). Baseline questionnaires were administered to collect demographic characteristics, educational attainment, occupation, medical and family histories, lifestyle factors, and the Essen Stroke Risk Score (ESRS). During a one-year telephone follow-up, we assessed the recurrence of stroke, modified Rankin Scale (mRS) scores, and changes in the ESRS from baseline. Result Young adults exhibited higher educational attainment and a distinct occupational distribution. The older adult cohort demonstrated a higher prevalence of preexisting medical conditions, as well as a more frequent family history of coronary heart disease and cancer. Young participants reported engaging in less physical exercise, domestic chores, and social interaction; however, they reported better sleep quality and a higher rate of cohabitation. In the unadjusted analysis, the young adult group exhibited a lower proportion of favorable functional outcomes (mRS 0–1: 60% vs. 65%), with an unadjusted odds ratio (OR) of 0.789 [95% confidence interval (CI): 0.670-0.930]. However, this disparity was attenuated and became non-significant following adjustment, the OR was 0.904 (95% CI: 0.730–1.120, p = 0.355). Ischemic stroke recurrence rates were comparable between the two groups (4% vs. 6%), whereas the older group exhibited a more pronounced change in ESRS scores. Conclusion The initially observed disparity in functional outcomes between young and older stroke patients appears to be heavily influenced by distinct, modifiable lifestyle factors. Early identification of and timely intervention against these prognostic factors are paramount for reducing the recurrence of stroke among young adults and minimizing its long-term sequelae.