scholarly journals Temporal Trends in Stroke-Related Memory Change

Stroke ◽  
2021 ◽  
Author(s):  
Chloe W. Eng ◽  
Elizabeth R. Mayeda ◽  
Paola Gilsanz ◽  
Rachel A. Whitmer ◽  
Anthony S. Kim ◽  
...  
Keyword(s):  
Linear Trend ◽  
Temporal Trends ◽  
Stroke Care ◽  
Incidence Rates ◽  
Stroke Onset ◽  
Linear Regression Models ◽  
Stroke Incidence ◽  
Memory Change ◽  
Incidence And Mortality ◽  
Nationally Representative

Background and Purpose: Findings from the Framingham Heart Study suggest that declines in dementia incidence rates over recent decades are partially due to decreases in stroke incidence and mortality; however, whether trends of declining dementia rates extend to survivors of incident stroke remains unclear. We investigated evidence for temporal trends in memory change related to incident stroke in a nationally representative cohort. Methods: Adults age 50+ in the HRS (Health and Retirement Study) were followed across three successive 6-year epochs (epoch 1: 1998–2004, n=16 781; epoch 2: 2004–2010, n=15 345; and epoch 3: 2010–2016; n=15 949). Participants were included in an epoch if they were stroke-free at the start of that epoch. Annual rates of change in a composite z-standardized memory score were compared using demographic-adjusted linear regression models for stroke-free participants, those who survived after stroke, and those who died after stroke, considering memory change before stroke, at the time of stroke, and for years following stroke. Results: Crude stroke incidence rates decreased from 8.5 per 1000 person-years in epoch 1 to 6.8 per 1000 person-years in epoch 3. Rates of memory change before and following stroke onset were similar across epochs. Memory decrement immediately after stroke onset attenuated from −0.37 points (95% CI, −0.44 to −0.29) in epoch 1 to −0.26 (95% CI, −0.33 to −0.18) points in epoch 2 and −0.25 (95% CI, −0.33 to −0.17) points in epoch 3 ( P value for linear trend=0.02). Conclusions: Decreases in stroke-related dementia in recent years may be partially attributable to smaller memory decrements immediately after stroke onset. Findings suggest reductions in stroke incidence and improvements in stroke care may also reduce population burden of dementia. Further investigations into whether temporal trends are attributable to improvements in stroke care are needed.

scholarly journals EXPRESS: COVID-19 AND STROKE – UNDERSTANDING THE RELATIONSHIP AND ADAPTING SERVICES. A GLOBAL WORLD STROKE ORGANISATION PERSPECTIVE

2021 ◽  
pp. 174749302110064
Author(s):  
Hugh S Markus ◽  
Sheila Cristina Ouriques Martins
Keyword(s):  
Large Scale ◽  
Stroke Care ◽  
Long Term Effects ◽  
Vessel Occlusion ◽  
Stroke Incidence ◽  
Stroke Research ◽  
Incidence And Mortality ◽  
Research Initiatives ◽  
Global World

A year ago the World Stroke Organisation (WSO) highlighted the enormous global impact of the COVID-19 pandemic on stroke care. In this review we consider a year later where we are now, what the future holds, and what the long term effects of the pandemic will be on stroke. Stroke occurs in about 1.4% of patients hospitalised with COVID-19 infection, who show an excess of large vessel occlusion and increased mortality. Despite this association, stroke presentations fell dramatically during the pandemic, although emerging data suggests that total stroke mortality may have risen with increased stroke deaths at home and in care homes. Strategies and guidelines have been developed to adapt stroke services worldwide, and protect healthcare workers. Adaptations include increasing use of telemedicine for all aspects of stroke care. The pandemic is exacerbating already marked global inequalities in stroke incidence and mortality. Lastly the pandemic has had a major impact on stroke research and funding, although it has also emphasised the importnace of large scale collaborative research initiatives.

scholarly journals Colorectal Cancer in Lebanon: Incidence, Temporal Trends, and Comparison to Regional and Western Countries

2021 ◽  
Vol 28 ◽  
pp. 107327482199686
Author(s):  
Najla A. Lakkis ◽  
Ola El-Kibbi ◽  
Mona H. Osman
Keyword(s):  
Colorectal Cancer ◽  
Cancer Incidence ◽  
Temporal Trends ◽  
Incidence Rates ◽  
Steady Increase ◽  
P Value ◽  
Western Countries ◽  
Incidence And Mortality ◽  
Colorectal Cancer Incidence ◽  
Males And Females

Global trends in the incidence and mortality rates of colorectal cancer show a steady increase with significant predilection to western developed countries, possibly linking it to westernized lifestyles among other risk factors. This study aims to investigate the incidence and trends of colorectal cancer in Lebanon, a country in the Middle East and North Africa region, and to compare these rates to those in regional and western countries. Colorectal cancer incidence data were extracted from the Lebanese National Cancer Registry for the currently available years 2005 to 2016. The calculated age-standardized incidence rates and age-specific rates were expressed as per 100,000 population. The age-standardized incidence rates of colorectal cancer in Lebanon increased from 16.3 and 13.0 per 100,000 in 2005 to 23.2 and 20.2 per 100,000 in 2016, among males and females, respectively. The incidences were higher for males, and they increased with age. The annual percent change was +4.36% and +4.45%, in males and females respectively (p-value < 0.05). There was a non-statistically significant trend of decrease in recent years (since 2012 in males and since 2011 in females). The age-standardized incidence rates in Lebanon were higher than those in the majority of the regional countries, but lower than the rates in developed western countries. There were high age-specific incidence rates at age groups 40-44 and 45-49 years in Lebanon in both males and females (with significant rising temporal trend) compared to other countries, including the ones reported to have the highest colorectal cancer age-standardized incidence rate worldwide. Therefore, the burden of colorectal cancer is significant in Lebanon. This raises the necessity to develop national strategies tailored to reduce colorectal cancer incidence through promoting healthy lifestyles, raising awareness, and early detection as of 40 years of age.

Abstract 137: Neighborhood Income and 30-day Readmissions for Stroke and Transient Ischemic Attack

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Judith H Lichtman ◽  
Erica C Leifheit-Limson ◽  
Yun Wang ◽  
Larry B Goldstein
Keyword(s):  
Transient Ischemic Attack ◽  
Stroke Care ◽  
Stroke Incidence ◽  
Logistic Regression Models ◽  
Post Stroke ◽  
Explanatory Factors ◽  
Nationally Representative ◽  
Ischemic Attack ◽  
The Relationship ◽  
Income Quartile

Background: Residence in a socioeconomically challenged neighborhood is associated with increased stroke incidence and shorter post-stroke survival. Little is known about the relationship between socioeconomic status and 30-day post-stroke readmissions. We used a nationally representative readmission database that includes both insured and uninsured patients to determine whether there is a relationship between community-level income and 30-day readmissions after stroke and transient ischemic attack (TIA). Methods: Hospitalizations were identified in the 2013 Nationwide Readmissions Database for patients aged ≥18y with subarachnoid hemorrhage (SAH; ICD-9 430), intracerebral hemorrhage (ICH; ICD-9 431), ischemic stroke (IS; ICD-9 433, 434, 436), and TIA (ICD-9 435). We used mixed logistic regression models with hospital-specific random effects to assess the relationship between community income level (measured according to the median household income quartile for a patient’s ZIP code) and 30-day readmissions. Models were stratified by age and adjusted for demographic and clinical characteristics. Results: There were 7,061 hospitalizations for SAH, 17,325 for ICH, 212,306 for IS, and 67,606 for TIA. In unadjusted analyses, 30-day readmission rates decreased with increasing income quartile for younger patients hospitalized with IS and SAH (figure). In adjusted analyses, this association persisted only among those with IS aged 18-44y for whom each quartile increase in income was associated with a 7% decrease in 30-day readmission (figure). There were no significant associations between income and 30-day readmission for SAH, ICH, and TIA. Conclusions: Overall, community income was not associated with readmission for hemorrhagic stroke and TIA, but higher income was associated with lower 30-day readmission for younger IS patients. Possible explanatory factors such as better access to post-stroke care warrant further research for this subgroup.

scholarly journals Incidence and mortality trends and geographic patterns of follicular lymphoma in Canada

2019 ◽  
Vol 26 (4) ◽  
Author(s):  
M. Le ◽  
F. M. Ghazawi ◽  
A. Alakel ◽  
E. Netchiporouk ◽  
E. Rahme ◽  
...  
Keyword(s):  
Follicular Lymphoma ◽  
Geographic Distribution ◽  
Mortality Rates ◽  
Vital Statistics ◽  
Incidence Rates ◽  
Western World ◽  
Linear Regression Models ◽  
Mortality Trends ◽  
Comprehensive Overview ◽  
Incidence And Mortality

Background Follicular lymphoma (FL) is the most common indolent lymphoma and the 2nd most common non- Hodgkin lymphoma, accounting for 10%–20% of all lymphomas in the Western world. Epidemiologic and geographic trends of FL in Canada have not been investigated. Our study’s objective was to analyze incidence and mortality rates and the geographic distribution of FL patients in Canada for 1992–2010.Methods Demographic and geographic patient data for FL cases were obtained using the Canadian Cancer Registry, the Registre quebecois du cancer, and the Canadian Vital Statistics database. Incidence and mortality rates and 95% confidence intervals were calculated per year and per geographic area. Rates were plotted using linear regression models to assess trends over time. Overall data were mapped using Microsoft Excel mapping software (Redmond, WA, U.S.A.) to identify case clusters across Canada.Results Approximately 22,625 patients were diagnosed with FL during 1992–2010. The age-standardized incidence rate of this malignancy in Canada was 38.3 cases per million individuals per year. Geographic analysis demonstrated that a number of Maritime provinces and Manitoba had the highest incidence rates, and that the provinces of Nova Scotia and Quebec had the highest mortality rates in the nation. Regional data demonstrated clustering of FL within cities or regions with high herbicide use, primary mining, and a strong manufacturing presence.Conclusions Our study provides a comprehensive overview of the FL burden and its geographic distribution in Canada. Regional clustering of this disease in concentrated industrial zones strongly suggests that multiple environmental factors might play a crucial role in the development of this lymphoma.

scholarly journals Temporal trends in the incidence, treatment patterns, and outcomes of coronary artery disease and peripheral artery disease in the UK, 2006–2015

2019 ◽  
Vol 41 (17) ◽  
pp. 1636-1649 ◽  
Author(s):  
Varun Sundaram ◽  
Chloe Bloom ◽  
Rosita Zakeri ◽  
Julian Halcox ◽  
Alexander Cohen ◽  
...  
Keyword(s):  
Secondary Prevention ◽  
Hospital Admissions ◽  
Temporal Trends ◽  
Population Level ◽  
Arterial Disease ◽  
Mortality Rates ◽  
Incidence Rates ◽  
Nationally Representative ◽  
Artery Disease ◽  
The Uk

Abstract Aims Most reports estimating national incidence rates of coronary (CAD) and peripheral arterial disease (PAD) have focused on stable outpatients or acute or elective hospital admissions, but not on the overall burden of disease. In this study, we report the changing trends in the population-level incidence of CAD and PAD, respectively from 2006 to 2015, statin utilization for secondary prevention and survival outcomes using multiple nationally representative data sources from the UK (primary care encounters, hospital admissions, and procedure-level data). Methods and results A nationally representative study of linked primary and secondary care electronic health records of 4.6 million individuals from the UK. We calculated crude and standardized annual incidence rates separately for CAD and PAD. Statin use for secondary prevention, trends in annual major vascular event rates, and mortality between 2006 and 2015, were estimated for CAD and PAD, respectively. We identified 160 376 and 70 753 patients with incident CAD and PAD, respectively. The age- and sex-standardized incidence of CAD was similar in 2006 (443 per 100 000 person-years) and 2015 [436 per 100 000 person-years; adjusted incidence rate ratio (IRR) 0.98, 95% confidence interval (CI) 0.96–1.00]. In contrast, there was a 15% decline in the standardized incidence of PAD (236 per 100 000 person-years in 2006 to 202 per 100 000 person-years in 2015; adjusted IRR 0.85, 95% CI 0.82–0.88). The proportion of incident CAD and PAD patients prescribed long-term statins, was only 66% and 55%, respectively and was less common amongst women, patients aged &gt;70 years, with heart failure, chronic lung disease, or depression. Cardiovascular mortality declined by 43% for incident CAD (adjusted IRR 0.57, 95% CI 0.50–0.64) between 2006 and 2015 but did not decline for incident PAD (adjusted IRR 0.84, 95% CI 0.70–1.00). Conclusion and relevance In the UK, the standardized incidence of CAD appears stable but mortality rates are falling, whereas the standardized incidence of PAD is falling but mortality rates are not.

Temporal trends in stroke incidence and case-fatality rates in Arcadia, Greece: A sequential, prospective, population-based study

2021 ◽  
pp. 174749302199559
Author(s):  
Eleni Karantali ◽  
Konstantinos Vemmos ◽  
Evangelos Tsampalas ◽  
Konstantinos Xynos ◽  
Persefoni Karachalia ◽  
...  
Keyword(s):  
Case Fatality Rate ◽  
Temporal Trends ◽  
Case Fatality ◽  
Population Based ◽  
Incidence Rates ◽  
European Population ◽  
Fatality Rate ◽  
Population Based Study ◽  
Stroke Incidence ◽  
Southern Greece

Background Stroke incidence and case-fatality are reported to decline in high-income countries during the last decades. Epidemiological studies are important for health services to organize prevention and treatment strategies. Aims The aim of this population-based study was to determine temporal trends of stroke incidence and case-fatality rates of first-ever stroke in Arcadia, a prefecture in southern Greece. Methods All first-ever stroke cases in the Arcadia prefecture were ascertained using the same standard criteria and multiple overlapping sources in three study periods: from November 1993 to October 1995; 2004; and 2015–2016. Crude and age-adjusted to European population incidence rates were compared using Poisson regression. Twenty-eight days case fatality rates were estimated and compared using the same method. Results In total, 1315 patients with first-ever stroke were identified. The age-standardized incidence to the European population was 252 per 100,000 person-years (95% CI 231–239) in 1993/1995, 252 (95% CI 223–286) in 2004, and 211 (192–232) in 2015/2016. The overall age- and sex-adjusted incidence rates fell by 16% (incidence rates ratio 0.84, 95% CI: 0.72–0.97). Similarly, 28-day case-fatality rate decreased by 28% (case fatality rate ratio = 0.72, 95% CI: 0.58–0.90). Conclusions This population-based study reports a significant decline in stroke incidence and mortality rates in southern Greece between 1993 and 2016.

scholarly journals Prediction of Cancer Incidence and Mortality in Korea, 2020

2020 ◽  
Vol 52 (2) ◽  
pp. 351-358 ◽  
Author(s):  
Kyu-Won Jung ◽  
Young-Joo Won ◽  
Seri Hong ◽  
Hyun-Joo Kong ◽  
Eun Sook Lee
Keyword(s):  
Regression Model ◽  
Cancer Incidence ◽  
Linear Trend ◽  
Cancer Control ◽  
Incidence Rates ◽  
Cancer Site ◽  
Mortality Data ◽  
Control Programs ◽  
Incidence Data ◽  
Incidence And Mortality

PurposeThis study aimed to report the projected cancer incidence and mortality for the year 2020 to estimate Korea’s current cancer burden.Materials and MethodsCancer incidence data from 1999 to 2017 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2018 were acquired from Statistics Korea. Cancer incidence and mortality were projected by fitting a linear regression model to observed age-specific cancer rates against observed years and then by multiplying the projected age-specific rates by the age-specific population. A <i>Joinpoint</i> regression model was used to determine the year in which the linear trend changed significantly; we only used the data of the latest trend.ResultsIn total, 243,263 new cancer cases and 80,546 cancer deaths are expected to occur in Korea in 2020. The most common cancer site is expected to be the lung, followed by the stomach, thyroid, colon/rectum, and breast. These five cancers types are expected to represent half of the overall burden of cancer in Korea. The most common type of cancer among people who die is expected to be lung cancer, followed by liver, colon/rectal, pancreatic, and stomach cancers.ConclusionThe incidence rates for all types of cancer in Korea are estimated to decrease gradually. These up-to-date estimates of the cancer burden in Korea could be an important resource for planning and evaluating cancer-control programs.

Abstract T MP63: Temporal Trends in Stroke Incidence Over the Past Twenty Years: Stroke Incidence Has Stabilized, Racial Disparity is not Improving

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Dawn Kleindorfer ◽  
Kathleen Alwell ◽  
Jane Khoury ◽  
Charles J Moomaw ◽  
Daniel Woo ◽  
...  
Keyword(s):  
Racial Disparities ◽  
Racial Disparity ◽  
Temporal Trends ◽  
Census Bureau ◽  
Incidence Rates ◽  
Ohio River ◽  
Stroke Subtype ◽  
Stroke Incidence ◽  
Physician Review ◽  
Health Significance

Introduction: We previously reported that the incidence of stroke was decreasing for whites but stable for blacks from 1993/94 to 2005. We sought to describe recent temporal trends and racial disparities in stroke incidence within our large, bi-racial population, by including a more recent study period. Methods: The Greater Cincinnati/Northern Kentucky region includes two southern Ohio and three Northern Kentucky counties on the Ohio River, a population of 1.3 million. Our study ascertained all hospitalized strokes that occurred in the population between 7/1/93 and 6/30/94 and in calendar years 1999, 2005, and 2010. For 2010, nursing review of medical records is complete but physician review is not; thus, rates for 2010 (calculated using a weighted estimation for events not completely reviewed) are preliminary. The denominator for the calculation of incidence rates (in those aged >20 years) was estimated from the U.S. Census Bureau website (www.census.gov). The 95% confidence intervals (CI) for the incidence rates were calculated assuming a Poisson distribution. Rates are age, gender, and race adjusted, as appropriate, and standardized to the 2000 U.S. population. Results: Stroke incidence rates stratified by subtype, race, and study period are presented in the Table. We project that stroke incidence did not significantly change in 2010 vs. 2005 for either blacks or whites, regardless of stroke subtype. Blacks have a substantially higher incidence of stroke compared with whites in all study periods. Discussion: In contrast to the trend seen from 1993-94 to 2005, there was no further decline of stroke incidence in whites in 2010, a disappointing finding of great public health significance. Stroke incidence in blacks remains unchanged over all periods. The substantial black > white racial disparity in stroke incidence has not changed over time. Further study is needed to understand and eventually reduce these racial disparities.

Abstract 72: Temporal Trends in Stroke Incidence Over Time by Sex and Age in the Greater Cincinnati Northern Kentucky Stroke Study

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Tracy E Madsen ◽  
Jane C Khoury ◽  
Michelle Leppert ◽  
Kathleen Alwell ◽  
Charles J Moomaw ◽  
...  
Keyword(s):  
Older Adults ◽  
Temporal Trends ◽  
Age Groups ◽  
Incidence Rates ◽  
Age Group ◽  
Bonferroni Correction ◽  
Stroke Incidence ◽  
Stroke Study ◽  
Trends Over Time ◽  
Over Time

Introduction: Data from the Greater Cincinnati/Northern Kentucky Stroke Study (GCNKSS) through 2010 showed that over time, stroke incidence rates decreased to a greater extent in men than in women. We aimed to determine whether this difference continued through 2015 and whether the differences are driven by particular age groups. Methods: Within the GCNKSS population of 1.3 million, all incident strokes among residents ≥20 years old were ascertained at all local hospitals during 7/93–6/94 and calendar years 1999, 2005, 2010, and 2015. Out-of-hospital cases were sampled. Sex-specific incidence rates per 100,000 were adjusted for age and race, standardized to the 2010 U.S. Census. Trends over time by sex were compared (overall and age-stratified); a Bonferroni correction was applied for multiple comparisons. Results: In total over the five study periods, there were 9721 incident strokes (ischemic, ICH, and SAH); 56.4% were women. Incidence of ischemic strokes decreased from 254 (95%CI 236,272) in 1993/4 to 177 (95%CI 164,189) in 2015 among men (p<.0001 for trend over time) and from 204 (95%CI 192,217) in 1993/4 to 151 (95%CI 141,161) in 2015 among women (p<.0001). Incidence of ICH/ SAH did not change significantly over time in either sex. In age-stratified analyses, among women, incidence of all strokes decreased among older adults (65–84 years) but not in other age categories (Figure). Among men, incidence over time decreased among older adults (65–84 and ≥ 85 years) but increased in young adults (20–44 years). Conclusions: Stroke incidence decreased between the early 1990s and 2015 for both sexes, contrary to previous data on trends through 2010 which demonstrated a significant decrease in men but not women. Temporal changes are being driven by the 65–84 year age group in both men and women, as well as the ≥ 85 age group in men. Future prevention strategies should target young and middle age adults for both sexes as well as those over 85 for women.

Sex Differences in Stroke Care and Outcome 2005–2018: Observations From the Swedish Stroke Register

Stroke ◽  
2021 ◽  
Author(s):  
Marie Eriksson ◽  
Signild Åsberg ◽  
Katharina Stibrant Sunnerhagen ◽  
Mia von Euler ◽  
Keyword(s):  
Functional Outcome ◽  
Survival Data ◽  
Oral Anticoagulants ◽  
Stroke Care ◽  
Stroke Onset ◽  
Absolute Difference ◽  
Lower Probability ◽  
Stroke Incidence ◽  
Men And Women ◽  
Stroke Register

Background and Purpose: Previous studies of stroke management and outcome in Sweden have revealed differences between men and women. We aimed to analyze if differences in stroke incidence, care, and outcome have altered over time. Methods: All stroke events registered in the Swedish Stroke Register 2005 to 2018 were included. Background variables and treatment were collected during the acute hospital stay. Survival data were obtained from the national cause of death register by individual linkage. We used unadjusted proportions and estimated age-adjusted marginal means, using a generalized linear model, to present outcome. Results: We identified 335 183 stroke events and a decreasing incidence in men and women 2005 to 2018. Men were on average younger than women (73.3 versus 78.1 years) at stroke onset. The age-adjusted proportion of reperfusion therapy 2005 to 2018 increased more rapidly in women than in men (2.3%–15.1% in men versus 1.4%–16.9% in women), but in 2018, women still had a lower probability of receiving thrombolysis within 30 minutes. Among patients with atrial fibrillation, oral anticoagulants at discharge increased more rapidly in women (31.2%–78.6% in men versus 26.7%–81.9% in women). Statins remained higher in men (36.9%–83.7% in men versus 32.3%–81.2% in women). Men had better functional outcome and survival after stroke. After adjustment for women’s higher age, more severe strokes, and background characteristics, the absolute difference in functional outcome was <1% and survival did not differ. Conclusions: Stroke incidence, care, and outcome show continuous improvements in Sweden, and previously reported differences between men and women become less evident. More severe strokes and older age in women at stroke onset are explanations to persisting differences.

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