title: Outcome and risk factors presented in old patients above 80 years of age versus younger patients after ischemic stroke.
abstract: BACKGROUND
  Older patients are associated with increased stroke prevalence, worse outcome, and risk of undertreatment in comparison with younger patients. The aim of the present study was to compare risk factor distribution and functional outcome in stroke survivors older and younger than 80 years.
  
  
  METHODS
  The analysis was based on consecutive patients admitted within 6 hours after stroke onset and discharged with ischemic stroke, surviving at least 3 months after ictus. To prevent bias, the analysis was based on a registry from before implementation of tissue plasminogen activator treatment; all patients received stroke unit care in accordance with the guidelines. The population was dichotomized into patients aged less than 80 years and 80 years of age or older. Modified Rankin Scale (mRS) score and Barthel Index (BI) were used to assess 3-month and 1-year outcome.
  
  
  RESULTS
  Patients 80 years of age or older presented with significantly more severe strokes than younger patients, median Scandinavian Stroke Scale score 39 vs 42 (P = .003). Median mRS score before stroke was significantly higher in patients aged 80 years or older (P < .001) and remained high 3 months and 1 year after ictus (P < .001); the BI was equivalently lower (P < .001). The decline in function was comparable between groups. Patients 80 years of age or older of whom the majority were women (P < .001) presented with atrial fibrillation (P < .001), and hypertension (P = .005).
  
  
  CONCLUSIONS
  Risk factors vary significantly with age, suggesting different stroke mechanisms. Patients older than 80 years experience more severe strokes and frequently have minor impairments before stroke. The increase in impairment after stroke is comparable with what is observed in younger patients, suggesting that good recovery after stroke may also be expected in older patients.
authors.affiliation: Department of Neurology, Copenhagen University Hospital, Bispebjerg, Copenhagen, Denmark. Electronic address: line.bentsen@regionh.dk.
authors.forename: Line
authors.initials: L
authors.lastname: Bentsen
authors.affiliation: Department of Neurology, Copenhagen University Hospital, Bispebjerg, Copenhagen, Denmark.
authors.forename: Louisa
authors.initials: L
authors.lastname: Christensen
authors.affiliation: Department of Radiology, Copenhagen University Hospital, Bispebjerg, Copenhagen, Denmark.
authors.forename: Anders
authors.initials: A
authors.lastname: Christensen
authors.affiliation: Department of Neurology, Copenhagen University Hospital, Bispebjerg, Copenhagen, Denmark.
authors.forename: Hanne
authors.initials: H
authors.lastname: Christensen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over / Q000706:statistics & numerical data*; D000375:Aging / Q000473:pathology*; D002545:Brain Ischemia / Q000401:mortality*; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000401:mortality*; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Ischemic stroke; functional ability; old patients; recovery