Clinical-neurological differences of patients with ischemic cerebrovascular disease under and over 65 years of age

Authors

Keywords:

cerebrovascular disorders, stroke, brain ischemia, risk factors, hypertension, signs and symptoms.

Abstract

Introduction: The ischemic cerebrovascular disease has a high frequency due to the population aging mainly.

Objective: To compare clinical characteristics of patients with ischemic cerebrovascular of two age groups.

Methods: A descriptive, cross-sectional, retrospective study was carried out in the Neurology and Neurosurgery Institute in Havana, from January to December, 2017 in patients with ischemic cerebrovascular disease; 36 individuals of both age groups. In this regard, demographic variables, risk factors, clinical manifestations, coma scale and neurological deficiency, etiology and localization of the ischemic ictus were analyzed.

Results: The 65 years group had a significant increase of hypertensive patients (88.9%). The average of the National Institute of Health stroke scale was superior in these patients (median [10-90 percentile]: 9.5 [4-19]). There was statistical increment of over 65 years patients with partial paralysis of the look and ataxia, but monoparesis and visual extinction in the age under 65 years. Such a scale had a statistical increase in the atherothrombotic and cardioembolic ictus in comparison with other etiologies in both patient groups. The over 65 years patients with just one risk factor or and those with hypertension had a higher punctuation of the scale.

Conclusions: The degree of neurological affectation was higher in over 65 years patients that had a risk factor and in those with hypertension. As a result it could be suggested that the molecular and pathophysiolologic mechanisms of these patients vary with the age.

Downloads

Download data is not yet available.

Author Biographies

Dhara Angeline Santana Trinidad, Hospital Dr. Félix María Goico. Santo Domingo

Especialista de primer grado en Neurologia. Servicio de Neurología

Marisol Peña Sánchez, Instituto de Neurología y Neurocirugía. La Habana

Investigador Auxiliar. Dpto de Genetica-Neurobiologia

Sergio González García, Facultad de Ciencias Médicas Dr. Miguel Enríquez, Universidad de Ciencias Médicas de La Habana. La Habana

Doctor en Ciencias. Investigador Titular. Departamento de Investigaciones

References

1. Feigin VL, Stark BA, Owens Johnson C, Roth GA, Bisignano C, Gebreheat Abadi G, et al. Global, regional and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the global burden of disease study 2019. Lancet Neurol. 2021 [citado 08/03/2023]20(10):795-820. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8443449/pdf/main.pdf

2. Cuba. Ministerio de Salud Pública; Dirección de Registros Médicos y Estadísticas de Salud. Anuario estadístico de salud 2022. La Habana: MINSAP; 2023 [citado 08/03/2023]. Disponible en: https://salud.msp.gob.cu/wp-content/Anuario/Anuario-2022.pdf

3. Cuba. Ministerio de Salud Pública; Dirección de Registros Médicos y Estadísticas de Salud. Anuario Estadístico de Salud 2020. La Habana: MINSAP; 2023 [citado 08/03/2023]. Disponible en: https://salud.msp.gob.cu/wp-content/Anuario/Anuario-2020.pdf

4. Yousufuddin M, Young N. Aging and ischemic stroke. Aging (Albany NY). 2019 [citado 08/03/2023];11(9):2542-4. Disponible en: https://www.aging-us.com/full/11/2542

5. Piloto González R, Herrera Miranda GL, Ramos Aguila YC, Mujica González DB, Gutiérrez Pérez M. Caracterización clínica-epidemiológica de la enfermedad cerebrovascular en el adulto mayor. Rev Cienc Méd Pinar Río. 2015 [citado 24/07/2022]19(6):996-1005. Disponible en: http://scielo.sld.cu/pdf/rpr/v19n6/rpr05615.pdf

6. Ramos Fernández O, Menéndez Rodríguez JC, Puentes Colombé M, Benítez Pozo OL, Sánchez Hernández E. Factores de riesgo de enfermedades cerebrovasculares en pacientes atendidos en unidad de cuidados intensivos municipal. Rev Cienc Méd Pinar Río. 2020 [citado 24/07/2022];24(2):e4190. Disponible en: https://revcmpinar.sld.cu/index.php/publicaciones/article/download/4190/pdf

7. Lemus Fajardo NM, Linares Cánovas LP, Lazo Herrera LA, Linares Cánovas LB. Caracterización de adultos mayores con ictus. Acta Médica del Centro. 2019 [citado 24/07/2022];13(3):304-14. Disponible en: https://revactamedicacentro.sld.cu/index.php/amc/article/download/985/1313

8. Murakami K, Asayama K, Satoh M, Inoue R, Tsubota Utsugi M, Hosaka M, et al. Risk Factors for Stroke among Young-Old and Old-Old Community-Dwelling Adults in Japan: The Ohasama Study. J Atheroscler Thromb. 2017 [citado 24/07/2022];24(3):290-300. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5383545/pdf/jat-24-290.pdf

9. Planes Fajardo M, Díaz-Perera Fernández G, Alonso Martínez MI, Calzada Fajardo A. Caracterización de los pacientes con ictus en una unidad de cuidados intensivos. Rev Finlay. 2021 [citado 24/07/2022];11(2):174-81. Disponible en: http://scielo.sld.cu/pdf/rf/v11n2/2221-2434-rf-11-02-174.pdf

10. Llibre Guerra JC, Valhuerdi Cepero A, Fernández Concepción O, Llibre Guerra JJ, Gutiérrez RF, Llibre Rodríguez JJ. Stroke incidence and risk factors in Havana and Matanzas, Cuba. Neurología (English edition). 2015 [citado 24/07/2022];30(8):488-95. Disponible en: https://www.elsevier.es/en-revista-neurologia-english-edition--495-articulo-stroke-incidence-risk-factors-in-S2173580815001170

11. Chen YM, Lin YJ, Po HL. Comparison of the Risk Factor Profile, Stroke Subtypes, and Outcomes between Stroke Patients Aged 65 Years or Younger and Elderly Stroke Patients: A Hospital-based Study. International Journal of Gerontology. 2013 [citado 24/07/2022];7(4):205-8. Disponible en: https://www.sciencedirect.com/science/article/pii/S1873959812001524?via%3Dihub

12. Samuthpongtorn C, Jereerat T, Suwanwela NC. Stroke risk factors, subtypes and outcome in elderly Thai patients. BMC Neurology. 2021 [citado 24/07/2022];21:322. Disponible en: https://bmcneurol.biomedcentral.com/counter/pdf/10.1186/s12883-021-02353-y.pdf

13. Furlan NE, Luvizutto GJ, Hamamoto Filho PT, Zanati Bazan SG, Pinheiro Modolo G, Ferreira NC, et al. The impact of age on mortality and disability in patients with ischemic stroke who underwent cerebral reperfusion therapy: a brazilian cohort study. Front Aging Neurosci. 2021 [citado 24/07/2022]13:649902. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8291127/pdf/fnagi-13-649902.pdf

14. Zathar Z, Karunatilleke A, Fawzy AM, Lip GYH. Atrial Fibrillation in Older People: Concepts and Controversies. Front Med (Lausanne). 2019 [citado 24/07/2022];6:175. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6694766/

15. Priya Reddy H, Jaganath A, Nagaraj N, Reddy YJ Jaganath A, Nagaraj N, Reddy VYJ. A study of age as a risk factor in ischemic stroke of elderly. Int J Res Med Sci. 2019 [citado 24/07/2022];7(5):1553-7. Disponible en: https://www.msjonline.org/index.php/ijrms/article/view/5691/4675

16. Linares Cánovas LP, Llanio González R, Márquez Hernández H. Ictus isquémico en pacientes mayores de 60 años atendidos en el hospital Dr. León Cuervo Rubio. UMP. 2019 [citado 24/07/2022];15(1). Disponible en: https://revgaleno.sld.cu/index.php/ump/article/view/316/html

17. Landi G, Cella E, Boccardi E, Musicco M. Lacunar versus non-lacunar infarcts: pathogenetic and prognostic differences. J Neurol Neurosurg Psychiatry. 1992 [citado 24/07/2022];55(6):441-5. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1014897/pdf/jnnpsyc00491-0015.pdf

18. Huggins HE, Brady M, Emma JP, Thaler DE, Leung LY. Differences in presenting symptoms of acute stroke among young and older adults. J Stroke Cerebrovasc Dis. 2020 [citado 24/07/2022];29(8):104871. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S1052305720302652?via%3Dihub

19. Heinemann AW, Harvey RL, McGuire JR, Ingberman D, Lovell L, Semik P, et al. Measurement properties of the NIH Stroke Scale during acute rehabilitation. Stroke. 1997 [citado 24/07/2022];28(6):1174-80. Disponible en: https://www.ahajournals.org/doi/10.1161/01.str.28.6.1174?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed

20. Pérez Rodríguez J, Álvarez Velázquez LL, Islas Hernández H, Rivera Alonso E. Factores de riesgo de enfermedades cerebrovasculares en adultos mayores de un consultorio médico de familia. Rev Cienc Méd Pinar Río. 2019 [citado 24/07/2022];23(6):849-56. Disponible en: https://revcmpinar.sld.cu/index.php/publicaciones/article/download/4072/pdf

Downloads

Published

2024-03-12

How to Cite

1.
Santana Trinidad DA, Peña Sánchez M, González García S. Clinical-neurological differences of patients with ischemic cerebrovascular disease under and over 65 years of age. MEDISAN [Internet]. 2024 Mar. 12 [cited 2025 Jun. 1];28(1):e4545. Available from: https://medisan.sld.cu/index.php/san/article/view/4545

Issue

Vol. 28 No. 1 (2024): ENERO-FEBRERO

Section

Original Articles

License

All the articles can be downloaded or read for free. The journal does not charge any amount of money to the authors for the reception, edition or the publication of the articles, making the whole process completely free. Medisan has no embargo period and it is published under the license of Creative Commons, International Non Commercial Recognition 4.0, which authorizes the copy, reproduction and the total or partial distribution of the articles in any format or platform, with the conditions of citing the source of information and not to be used for profitable purposes.