Abstract WP122: National-level estimates of life expectancy by stroke history in Americans aged 50+ over two periods: 1996-2006 and 2008-2018

Introduction: Life expectancy in the U.S. population has improved over the past several decades. Less is known about trends in life expectancy among those who have experienced a stroke. We used nationally representative data to estimate life expectancy among those with and without a previous stroke history over two discrete periods: 1996-2006 and 2008-2018. Hypothesis: Given secular increases in U.S. life expectancy and improved treatment and management of stroke, we hypothesized that life expectancy after stroke has increased over time. Methods: Data was from the nationally representative and longitudinal Health and Retirement Study (HRS). The analytical sample included 17,451 and 16,870 individuals in 1996-2006 and 2008-2018, respectively. Multivariable Cox proportional hazard models were used to estimate the hazard ratios of dying associated with a previous stroke. Discrete time multistate models were used to estimate period-based life expectancy at age 50 (LE50) by stroke history status and sex in each period. Results: The mean age of the sample was 68 years. Ten percent of the sample had a previous stroke in 1996 and 7% in 2008. Eight percent of the sample died across the two periods. LE50 was 29.6 years (95% CI: 29.4, 29.8) in 1996-2006 and 30.7 years (95% CI: 31.4, 31.0) in 2008-2018 (both sexes combined). Among those without a prior stroke history, LE50 increased by 1.7 years (95% CI: 0.7-2.5) in men and 0.7 years (95% CI: 0.3-1.2) in women across the two periods. LE50 among those with a prior stroke history increased by 3.5 years (95% CI: 0.4-6.3) in men and 3.0 years in women (95% CI: 0.9-5.1) across the two periods. Conclusions: This study fills gaps in our understanding of life expectancy after stroke at a national level. Results indicate that increases in life expectancy among those with a stroke history have outpaced life expectancy among those without a stroke history potentially pointing to successes in improved vascular risk factor treatment and better management of post-stroke sequalae.