Neurology-Stroke: Study Shows That Nearly 30 Percent Of Young American Adults Do Not Know Common Stroke Symptoms
: A new study by researchers from Yale University, Houston Methodist DeBakey Heart and Vascular Center, University of Texas Southwestern Medical Center, West Virginia University School of Medicine, Houston Methodist Research Institute and Medstar Union Memorial Hospital-Baltimore has found that almost 30 percent of young American adults do not know what are the symptoms of a stroke or even know how to identify if a person close to them was having a stroke. In the current COVID-19 scenario where infections with the SARS-Cov-2 virus seems to lead to a high incidence of strokes and even in recovered COVID-19 patients, being able to recognize the symptoms of a stroke is very important and critical in making sure that one gets medical attention as soon as possible.
The study findings are published in the peer reviewed journal: Stroke, a journal of the American Heart Association. https://www.ahajournals.org/doi/10.1161/STROKEAHA.120.031137
Prior to the COVID-19 pandemic, stroke was the fifth cause of death and a leading cause of disability in the United States. Each year, about 10% to 15% of the nearly 795,000 people in the U.S. who have a stroke are young adults ie between ages 18 and 45. Recent studies suggest stroke incidence is declining in the general population, yet, stroke incidence and hospitalizations have increased by more than 40% in young adults in the past several decades.
In the current COVID-19 pandemic era, the incidence of strokes has even been much higher.
Study author Dr Khurram Nasir, M.D., M.P.H., M.Sc., chief of the division of cardiovascular prevention and wellness at Houston Methodist DeBakey Heart and Vascular Center in Houston, Texas told Thailand Medical News, "While the medical community has made significant improvements to reduce the severity and complications of strokes with early interventions, these efforts are of limited value if patients do not recognize stroke symptoms. Time is critical for treating stroke. The earlier people recognize symptoms, the better their chances are to reduce long-term disability from stroke."
In order to assess how well the U.S. population understands common stroke symptoms, Dr Nasir and colleagues reviewed responses to the 2017 National Health Interview Survey. As part of the annual survey, adults are asked several questions about stroke including identifying five of the most common stroke symptoms, which in this survey were noted as:
-Numbness of face/arm/leg;
-Difficulty walking/dizziness/loss of balance;
-Trouble seeing in one/both eyes; and
For the study, the study team analyzed a targeted subset of the full survey, ie answers from 9,844 younger adults, under age 45, which statistically represents 107.2 million young adults in the U.S. population. Average age of the younger respondents was 31, half were women and 62.2% were non-Hispanic white.
Significantly, the researchers found:
-Almost one in three (28.9%) respondents was not aware of all five common stroke symptoms.
-About 3% of respondents, representing nearly 3 million young adults, were not aware of any stroke symptom.
-Hispanic adults and adults not born in the U.S. were about twice as likely to be unaware of any of the common stroke symptoms, compared to non-Hispanic White people and those born in the U.S.
-Young adults with a high school diploma or lower education level were nearly three-times as likely to be unaware of any stroke symptom, compared to young adults with higher education levels,
Dr Nasir said the high number of young adults who remain unaware of stroke symptoms is surprising, and along with continued social inequities, these are major concerns.
Dr Nasir added, "With the growing risk of stroke among younger adults in the U.S., our study sheds light on particularly vulnerable individuals and communities that already experience a disproportionately greater burden of stroke and cardiovascular risk factors, as well as reduced access to health care services. We hope that highlighting the continued impact of current health disparities may advance focused public health strategies and educational initiatives to increase awareness of and appropriate response to stroke symptoms."
The study team also found that nearly 3% of young adults surveyed would not contact emergency medical services if they did see someone experiencing perceived stroke symptoms.
Dr Mitchell S. V. Elkind, M.D., M.S., FAHA, FAAN, president of the American Heart Association said, "That finding could be a matter of life and death. With proper, timely medical attention, stroke is largely treatable. The faster you are treated, the more likely you are to minimize the long-term effects of a stroke and even prevent death."
Dr Elkind is also a professor of neurology and epidemiology at Vagelos College of Physicians and Surgeons and attending neurologist at New York-Presbyterian/Columbia University Irving Medical Center in New York City.
He further added, "Calling 9-1-1 is critical because trained EMS personnel can start the care protocol en route to the hospital and have specialized teams standing by, ready at the hospital to administer the most appropriate treatment immediately."
Dr Elkind says the American Heart Association/American Stroke Association advocates the use of the letters in "F.A.S.T
." to spot stroke signs and to know when to call 9-1-1:
-Time to call 9-1-1 or any health emergency services
Dr Nasir said F.A.S.T. is among a number of creative and community-engaged initiatives that have aimed to increase public recognition of common stroke symptoms, and he stresses an urgency to address contemporary health inequities head-on through such tailored and multidisciplinary public health approaches.
He said, "Our results show that novel strategies are required at the population level to increase symptom awareness among young adults, where we have found a higher-risk population with substantial variations in symptom recognition.”
The study team said that a possible limitation of the study is that those surveyed responded with a "yes" or "no" when asked if something was a common stroke symptom. This could lead to an overestimation of actual awareness rates.
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