Global, regional, and national epidemiology of ischemic stroke in young adults, 1990-2021

J Neurol. 2025 Apr 22;272(5):354. doi: 10.1007/s00415-025-13082-4.

Abstract

Introduction: This study, for the first time, utilizes the 2021 GBD data to analyze the disease burden of ischemic stroke in young adults (defined as aged 20-50 years) globally, aiming to provide a scientific basis for public health interventions.

Methods: The study employs GBD data from 1990 to 2021 to analyze the incidence, mortality, and disability-adjusted life years (DALYs) of ischemic stroke in young adults. We assess differences in disease burden across regions with varying levels of socioeconomic development using the Sociodemographic Index (SDI). We also utilize Joinpoint regression and the Bayesian Age-Period-Cohort (BAPC) model to analyze temporal trends and predict future burdens. Additionally, we examine the distribution of ischemic stroke in young adults across different ages, genders, and regions.

Results: In 2021, the number of deaths and incidences increased; however, the age-standardized mortality rate decreased. The Middle SDI region had the highest number of deaths and incidence, while the High SDI region had the lowest number of deaths. Southeast Asia had the highest estimated annual percentage change (EAPC) in mortality Age-Standardized Rate (ASR), East Asia had the highest EAPC in incidence ASR. The incidence was highest in the age group of 40-49 years, with a shift from older to middle-aged populations. The mortality rate in males was generally higher than in females. The age-standardized incidence rate of ischemic stroke in young adults is expected to continue declining in the future, while the number of cases is likely to keep increasing.

Conclusion: Despite a global decline of mortality and incidence in all SDI regions, the disease burden continues to rise due to population growth and aging, especially in Middle SDI regions. The study predicts ongoing increases in disease burden, highlighting the impact of gender and socioeconomic factors. Further research is needed to prevent the disease from affecting younger populations.

Keywords: Global Burden of Disease; Ischemic stroke; Trends analysis; Young adults.

MeSH terms

  • Adult
  • Disability-Adjusted Life Years
  • Female
  • Global Health* / statistics & numerical data
  • Humans
  • Incidence
  • Ischemic Stroke* / epidemiology
  • Ischemic Stroke* / mortality
  • Male
  • Middle Aged
  • Young Adult