Stroke in younger adults
Many younger adults are affected by stroke each year. Although the effects of stroke are the same in different age groups, younger people are likely to have different concerns about their family, their finances, and social and employment issues. This factsheet explains the causes and effects of stroke in younger adults, and outlines the help and support that is available.Stroke is often thought to only affect older people. Yet every year around 10,000 people under the age of 55 have a stroke and of these, a thousand are under the age of 30. In younger age groups men are more likely to be affected than women.
A stroke occurs when the blood supply to the brain is disrupted, either because a blood clot causes a blockage (ischaemic stroke) or a blood vessel bursts, resulting in a bleed within or around the brain (haemorrhagic stroke). Because the brain depends on a constant supply of oxygen-rich blood, this leads to death or damage to brain cells.
The majority of strokes are ischaemic. Only around 20 per cent of all strokes are haemorrhagic, but this type is much more likely to affect younger adults, often as a result of a weakness in part of the vascular system. For instance, a weakness in the wall of an artery – an aneurysm – can balloon out and burst, allowing blood to leak into the brain. Arteriovenous malformations (AVMs) develop when the structure of the arteries and veins is abnormal and tangled. These are fragile and can easily rupture, leading to bleeding into the brain. Untreated high blood pressure contributes to this, as it weakens the walls of the arteries.
Your doctor will try to establish whether your stroke was ischaemic or haemorrhagic. This is important, because the type of stroke you had and its cause may affect the type of treatment you need and the after care you receive.
Who is at risk?
- Anyone can have a stroke, including babies and children. However, in adults the risk factors are much the same regardless of age, and include:
- Smoking. This can affect blood clotting and also narrows the arteries, making it easier for blockages to occur.
- High blood pressure. Though more common as you get older, this may affect younger people, for instance if there is a tendency to high blood pressure in the family.
- Other medical conditions. For example, Type 2 diabetes, heart problems or sickle cell disease increase the risk because they affect the health of the vascular system.
- Ethnic background. Asian, African and African-Caribbean people are at greater risk of a stroke. African-Caribbeans, in particular, tend to have a first stroke at a younger age than people from other ethnic groups.
- Regular heavy drinking. This can, over time, raise blood pressure and increase your risk of stroke. Binge drinking can also raise blood pressure to dangerously high levels.
- Recreational drugs. Cocaine, amphetamines and ecstasy increase the risk of stroke, especially in people with AVMs.
- Combined oral contraceptive pills. The Pill may make the blood more likely to clot, especially in women with other risk factors, and may also raise blood pressure.
What can you do
Although further strokes cannot always be prevented, the risk can often be reduced. It is important, therefore, to try to determine the cause of your stroke.Your doctor will be able to advise on the best way to reduce your individual risk. For example, if your stroke was due to high blood pressure, you may need regular medication to control it. If your stroke was due to a clot or blood-clotting problem, you may need medication to help thin the blood and prevent further clots from developing. If you have another condition, such as diabetes, it is crucial to keep it well controlled.
Following a healthy lifestyle also helps to reduce your risk. This may include giving up smoking, losing any excess weight, taking regular exercise (if possible), reducing your alcohol intake and eating a diet low in saturated fat and salt and high in fruit and vegetables.
The effects of stroke
Medically, the effects of stroke are the same whether you are young or old. However, in the younger person they may not be complicated by other diseases as they may be in someone who is older.The effects can vary enormously, depending on the area of the brain that has been damaged and the extent of the damage. The most common ones include:
- Paralysis, weakness or numbness down one side
- Communication difficulties (problems with speech, reading, writing and comprehension)
- Difficulties with mental processes, such as learning, concentration and memory.
Other effects include visual problems, tiredness, incontinence and swallowing difficulties. For most, these will be relatively minor and /or short-term, but some people will be left with more serious, long-term disabilities.
Even though the physical after effects of a stroke are usually the same regardless of age, the practical implications may have different family, financial, social and employment concerns.
Depression
Depression is common after stroke in all age groups. In fact, it is estimated that around half of those who have a stroke experience significant depression at some point within the first year. It can begin soon after the stroke or many weeks later, and can range from mild to severe. There are various reasons for this. The physical damage to the brain can trigger depression by disrupting the electrical activity, which generates and controls emotions, perceptions and thoughts.Depression may also stem from a variety of emotional reactions towards the stroke itself, such as considering the effect of any lasting disabilities on your present way of life, as well as your hopes and plans for the future. For many, depression may result from a combination of these.
What you can do
Depression is an illness not a weakness, and it can seriously delay your recovery. There is much that can be done to help. Speak to your doctor and get medical treatment, which may include taking antidepressants and, if appropriate, counselling and psychotherapy. Depression can make people feel isolated and withdrawn. Talking to others can be a big help. If you are able to, keep talking to family and friends – don’t push people away or assume you are a burden. Keep in touch with friends and relatives. Meeting people regularly is an important weapon against depression. Try to keep active, if possible. Physical activity, no matter how gentle, can help lift your mood and also ease tiredness and fatigue.Emotional impact
As with other long-term illness, it can take time for the full implications of your stroke to sink in. For example, you may feel isolated by your experience, especially as stroke is not common in younger people. If you need substantial care, you may feel that others have taken over control of your life, and that you are relying on them to make decisions on your behalf.Anyone who has a stroke may have a range of emotional reactions, including grieving for the loss of their past life; feelings of frustration and anger; fear and uncertainty over the future; and loss of confidence and self-esteem.
