Changes in stroke characteristics with age: experience from a South Asian prospective hospital-based stroke registry

Understanding the differences in stroke characteristics across age groups helps improve stroke outcomes for patients. However, data on age-related differences in stroke from developing countries are lacking. We aimed to describe differences in stroke characteristics and outcomes with age in patients with stroke admitted to a tertiary care hospital in Sri Lanka. We studied all patients with acute strokes admitted to a tertiary care hospital in Sri Lanka over 3 years. We compared demographics, stroke characteristics, and outcomes across three age groups: <65, 65–79, and ≥ 80 years. We studied stroke associations and factors related to functional dependence using multiple logistic regression. A total of 949 patients were studied (40.8% females, mean age 63±12.0 years, ≥ 65 years-49.8%, ≥ 80 years-7.6%). On risk factor assessment, atrial fibrillation ( p = 0.002) and ischaemic heart disease ( p = 0.011) were more common in old age, whereas diabetes ( p = 0.024), smoking ( p < 0.0001), alcohol use ( p < 0.0001), and family history of stroke ( p = 0.001) were more common in younger patients. There were no differences between the groups in treatment-seeking delays. Features of severe stroke (altered consciousness ( p < 0.0001), seizures ( p = 0.006), dysphasia ( p = 0.003), dysphagia ( p < 0.0001), bladder involvement ( p < 0.0001)) increased with age. No differences were noted in the stroke subtypes. On multivariate analysis, older age was associated with in-hospital mortality ( p = 0.007) but not with stroke severity ( p = 0.245) or early functional dependence (mRS ≥ 3, p = 0.071). Older patients with stroke had different clinical profiles and risk factors for stroke. In-hospital mortality was higher in older patients. However, age was not associated with stroke severity or early functional disability.