More Elderly Might Benefit From Stroke Treatment


Elderly under-represented in stroke research; receive less treatment than younger patients

11 oct 2009-- Given an aging population, the prevention and treatment of stroke in the very elderly -- who are under-represented in studies regarding therapy -- will become more important, according to research published online Oct. 2 in The Lancet Neurology.

Nerses Sanossian, M.D., of the University of Southern California and Bruce Ovbiagele, M.D., of the University of California, both in Los Angeles, reviewed data on stroke prevention and treatment in the very elderly against a backdrop of increasing life expectancy and a much higher risk of stroke in older age.

Research has shown that antihypertensive therapy can reduce stroke incidence and mortality in those over 80 years of age, and that statin therapy may benefit elderly people at high risk of stroke. Some data also supports the safety and effectiveness of anticoagulation in individuals over 75 with atrial fibrillation, though this therapy is often not given due to fear of complications. Thrombolysis with alteplase may be helpful for treatment of acute stroke in the very elderly, but should be considered on an individual basis.

"Perhaps not surprisingly, the use of evidence-based stroke treatments in patients much older than the clinical trial population in which these treatments were initially tested is of great concern to many clinicians. However, a growing body of evidence indicates that these therapies can be feasibly and effectively used in very elderly patients with stroke or at risk of stroke," the authors conclude.

Abstract
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