Difference in Clinical Features and Risk Factors of Ischemic Stroke Between Young and Elderly Adults: A Retrospective Observation from an Island Population

Ling Li,1,2 Jingjing Liu,3 Yiwei Xu,2 Jiaoxuan Dong,2 Songbin He,2 Fangyu Dai,2 Haipeng Liu4– 6 1Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People’s Republic of China; 2Department of Neurology, Zhoushan Hospital, Wenzhou Medical University, Zhoushan, People’s Republic of China; 3Department of Pulmonary and Critical Care Medicine, General Hospital of Pingmei Shenma Group, Pingdingshan, People’s Republic of China; 4Centre for Technology Transfer, Universidad Santa Paula, Curridabat, San José, Costa Rica; 5National Medical Research Association, Leicester, UK; 6Cardiovascular Analytics Group, Hong Kong SAR, People’s Republic of ChinaCorrespondence: Fangyu Dai, Department of Neurology, Zhoushan Hospital, Wenzhou Medical University, No. 739 Dingshen Road, Lincheng New District, Zhoushan, People’s Republic of China, Email [email protected] Haipeng Liu, Centre for Technology Transfer, Universidad Santa Paula, C123, Ayarco Sur, Curridabat, San José Province, 11803, Costa Rica, Email [email protected]: The incidence of ischemic stroke in young adults has been increasing. However, there is a lack of in-depth understanding of relevant clinical features, particularly in specific geographic and climatic settings. This study aimed to comprehensively investigate the clinical features, including etiology and characteristics, of ischemic stroke in young adults compared with elderly patients from an island population characterized by a subtropical monsoon climate.Patients and Methods: A total of 1,010 patients with ischemic stroke were included and divided into a young group (454 patients, aged 18– 50 years) and an elderly group (556 patients, aged > 50 years). Clinical and radiological data were collected and compared between the two groups. Continuous and categorical variables were compared using the t-test (or non-parametric tests) and chi-square test, respectively. Binary logistic regression analyses were used to investigate differences between the two groups.Results: Body mass index, leukocyte count, lymphocyte count, uric acid, and triglyceride levels were higher in the young group than in the elderly group, whereas vitamin B12 levels were lower. In addition, the proportions of cardiogenic embolism, other etiologies and unexplained strokes, and infarcts in the basal ganglia region were significantly higher in the young group. These results suggest age-related differences in clinical characteristics within this island study population.Conclusion: High body mass index, leukocyte count, uric acid, triglyceride levels, and low vitamin B12 levels are associated with ischemic stroke in young adults. Young adult patients had a higher prevalence of basal ganglia infarction, with a different subtype distribution from elderly patients. These findings highlight the importance of considering geographic specificity and age-related differences when developing stroke prevention and management strategies, formulating public health policies, and allocating medical resources for ischemic stroke.Keywords: ischemic stroke, young adults, cardioembolism, island population, clinical features