Understanding Stroke In Seniors: Symptoms, Causes & Risk Factors

Stroke is the leading cause of disability and death in the very elderly (those over the age of 80). Did you know 75% of strokes occur in people over 65? While these are worrying numbers, knowing more about the condition can help seniors and their caretakers spot a stroke early and get prompt treatment.

Before we delve deeper into the causes, risk factors, symptoms and signs of stroke in seniors, we must understand what it is.

A stroke occurs when the normal blood supply to your brain is interrupted. This can happen when a blood vessel gets blocked or as a consequence of it bursting or breaking. When this happens, the brain cells do not get sufficient oxygen and eventually die.

A stroke is as serious as a heart attack; acting quickly can decrease disability. While strokes can occur at any age, the risk increases with age.

Types of stroke

Before we learn about the causes and signs of stroke in seniors, we must know that there are two primary types of strokes:

Ischaemic stroke

• This type of stroke is most common and occurs when a blood clot blocks the blood vessel or, due to the narrowing of the blood vessel, reduces blood flow to the brain. This prevents adequate amounts of oxygen from reaching the brain cells.
• Ischaemic strokes can occur due to thrombosis (a clot that forms in a blood vessel of the brain or neck), embolism (a clot that moves from one part of the body to another, blocking the blood supply to the brain) or stenosis (arterial narrowing due to fatty deposits in them).

Haemorrhagic stroke

This type of stroke results from a blood vessel bursting, leading to blood leakage into and around the brain.

It also reduces the oxygen supply to the brain cells and exposes them to toxic substances, causing them to die.

The bleeding also increases pressure inside the skull, which can compress brain tissue and cause damage.

What are the common causes of stroke in seniors

High blood pressure: This is the leading cause of stroke in seniors. Over time, high blood pressure damages the blood vessels in the brain, leading to a stroke.

Atrial fibrillation: Atrial fibrillation is a condition where the heart beats irregularly. This can cause blood clots in the heart, which can then travel to the brain and cause a stroke.

Diabetes: Diabetes can damage the blood vessels, increasing the risk of stroke.

Smoking: This is a significant risk factor for stroke, as it damages the blood vessels and increases the risk of blood clots.

High cholesterol: High cholesterol levels can lead to plaque buildup in the blood vessels, increasing the risk of stroke.

Obesity: Obesity is a risk factor for several health conditions, including stroke. Excess weight can increase the risk of high blood pressure, diabetes, and high cholesterol, all of which can contribute to stroke risk.

Family history: Seniors with a family history of stroke are at a higher risk of experiencing a stroke themselves.

How to spot a stroke: signs and symptoms

The symptoms of stroke don’t last very long. However, spotting these symptoms in yourself or someone around you can be life-saving! Here are some signs and symptoms of stroke in seniors:

• A sudden feeling of numbness in the arm, leg or face (usually on one side of the body)
• Sudden difficulty in speaking or understanding speech
• Dizziness, loss of balance or coordination, and confusion
• Difficulty in walking
• A sudden problem in seeing with one or both eyes
• Sudden severe headache with no cause

A few signs of stroke in the elderly that are considered dangerous and warrant urgent medical care and attention are:

• Drowsiness
• Nausea or vomiting
• Double vision

Risk factors for stroke among seniors

Besides increasing age, several​​ factors can increase an individual’s risk of developing a stroke.

Here are some risk factors for stroke among seniors:

• High blood pressure
• Diabetes
• High blood cholesterol levels
• Obesity
• Lack of physical activity
• Use of tobacco or exposure to second-hand smoke
• Pre-existing heart disease
• Carotid or other arterial diseases
• Blood disorders like sickle cell anaemia
• Excessive alcohol consumption
• Drug abuse
• Gender (males are at higher risk)
• Family history of the condition
• Race (African-Americans are at higher risk)
• Previous history of stroke

Some factors that may put women at high risk of developing stroke include hormonal changes that occur during menopause. Women with high blood pressure may also be at a heightened risk of a stroke.

Management of stroke in seniors

A doctor usually diagnoses a stroke based on the individual’s symptoms, medical history, physical examination and imaging tests like a CT scan. The specific treatment plan for stroke in older adults will depend on the stroke's severity, the individual's underlying health conditions, and other factors.

Typical stroke management includes medications, surgery and rehabilitation. The treatment also varies for ischaemic and haemorrhagic strokes.

Ischaemic stroke

Using medications is the most common treatment for ischaemic strokes caused by blood clots. Antithrombotics (drugs that prevent new clot formation) and thrombolytics (medications that dissolve a clot) are routinely used for these strokes.

Haemorrhagic stroke

A surgeon determines the source of the bleeding and controls it. Since haemorrhagic strokes can worsen with thrombolytics, it is crucial to determine the type of stroke before treating it. Haemorrhagic strokes usually require surgery and other procedures to control bleeding and release pressure in the brain.

In people who have already experienced a stroke episode and are at high risk of developing another one, a few procedures may be recommended, including

• Angioplasty (insertion and inflation of a balloon within the blocked or narrowed blood vessel to restore blood flow)
• Stenting (placement of a small mesh tube to keep the blood vessel open)
• Carotid endarterectomy (procedure to remove fatty deposits blocking the blood vessels supplying the brain)
• Endovascular thrombectomy (large clots are removed using specialised devices)

Rehabilitation is a significant step in the management of stroke. Rehabilitative therapies, like physical, speech, and occupational therapy, can help older adults regain function and independence after a stroke. Rehabilitation programs may involve exercises to improve mobility and strength and strategies for improving speech, swallowing, and fine motor skills.

How can seniors lower their risk for strokes

While ageing does increase the risk of many health conditions among seniors, serious illnesses like strokes are preventable.      

If you are thinking about how to prevent stroke in seniors, here are some steps that may help:

• Keep your blood pressure numbers in check: Regular monitoring of blood pressure and keeping them under normal limits can help you lower your risk of a stroke.
• If you have high blood pressure, follow your doctor's instructions and medications to lower it.
• Control your blood sugar levels: If you have diabetes, keeping your blood sugar levels under control can reduce your stroke risk.
• Keep your cholesterol levels within normal range: High cholesterol can increase the fatty deposits in the blood vessels, precipitating a stroke. It is important to control your blood cholesterol levels and keep them in check.
• Quit smoking: It reduces your risk for heart disease and stroke.
• Eat a healthy balanced diet: Seniors must include foods rich in fibre, low in cholesterol, and saturated fats to lower their risk for a stroke. Eating fresh vegetables and fruits, whole grains, pulses, legumes and lean proteins are recommended.
• Stay physically active: Moderate-intensity exercises like brisk walking, jogging, or swimming are great exercises to help seniors keep their health parameters in the normal range and prevent events like a stroke in seniors.

Conclusion

Stroke in seniors is a serious medical condition that can have devastating effects on seniors. However, understanding the symptoms, causes, and risk factors of stroke can help seniors take steps to reduce their risk and seek prompt medical attention if needed.

Maintaining a healthy lifestyle, managing underlying health conditions, and seeking regular medical care are all essential for reducing the risk of stroke. Staying informed and taking steps to protect their health can help seniors enjoy a better quality of life and reduce their risk of stroke.