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1 In 3 Young Adults In The US Don't Know Stroke Symptoms, Especially Those at High Risk

Ashley Jordan Ferira, Ph.D., RDN
November 8, 2020
Ashley Jordan Ferira, Ph.D., RDN
mbg Vice President of Scientific Affairs
By Ashley Jordan Ferira, Ph.D., RDN
mbg Vice President of Scientific Affairs
Ashley Jordan Ferira, Ph.D., RDN is Vice President of Scientific Affairs at mindbodygreen. She received her bachelor's degree in Biological Basis of Behavior from the University of Pennsylvania and Ph.D. in Foods and Nutrition from the University of Georgia.
Image by Emotion Matters / Stocksy
November 8, 2020

You probably know someone who's suffered a stroke. As a leading cause of death (No. 5) and disability around the world, it's just that common. Every 40 seconds, a person suffers a stroke in the United States, and every four minutes, someone loses their life to a stroke. In all, nearly 800,000 people in the U.S. have a stroke each year. 

Speed is everything when it comes to stroke detection, diagnosis, and treatment. Yet, a new study finds 1 in 3 young adults don't know the symptoms of a stroke. Let's dig into that, shall we?

Stroke basics.

To back things up for a second, stroke is a type of cardiovascular disease. When the blood supply to part of the brain is blocked (ischemic stroke) or a blood vessel in the brain bursts (hemorrhagic stroke), brain cells are damaged or die. The overwhelming majority of strokes (87%) are the ischemic type, which are usually caused by a blood clot or atherosclerotic plaque buildup over time. From problems speaking and seeing to full-on paralysis, the effects of strokes can be debilitating and even deadly. 

Strokes are not an older-person problem. They are an everybody problem, and while stroke incidence has decreased overall the past few decades, there's a clear, alarming outlier in the data—young adults. Strokes are on the rise in young adults1 (ages 18 to 45), who account for 10 to 15%2 of total strokes.

New study tests whether young adults know signs of stroke.

Do you know the top five signs of a stroke? If not, you're not alone according to this recent study published in the journal Stroke. The research was led by Khurram Nasir, M.D., MPH, M.Sc., an expert in preventive cardiology from Methodist Hospital in Houston, Texas. In this study, Nasir and colleagues examined how well young adults in the U.S. know common stroke symptoms.

Study author Nasir shares that, "While the medical community has made significant improvements to reduce the severity and complications of strokes with early interventions, these efforts are of limited value if patients do not recognize stroke symptoms."

Who were the study participants?

The data came from the 2017 National Health Interview Survey, an annual survey3 that uses a nationally representative U.S. sample. Researchers looked at a targeted young adult subset (9,844 individuals) of the more than 24,000 total participants. 

These young adults were 18 to 45 years old and made up almost 40% of the individuals in the total study. When extrapolated to the overall U.S. population, this sample represents over 100 million young adults. In this study, the average age of young adults was 31. There was a 50-50 split male-to-female, and 62% were non-Hispanic white. 

What did the study find?

The young adults in this study were asked whether they recognized (yes or no) these five common symptoms of stroke.

  • Numbness of face/arm/leg
  • Confusion/trouble speaking
  • Difficulty walking/dizziness/loss of balance
  • Trouble seeing in one/both eyes
  • Severe headache

Over 30% of young adults—nearly 1 in 3—did not know all five stroke symptoms. Specifically, 28.9% didn't know all five symptoms, while 2.7% failed to recognize at least one symptom. The fact that nearly one-third of young adults lack awareness of the top signs of stroke is important because as mentioned before, stroke incidence is up in young adults. 

In fact, stroke incidence and hospitalization rates are clearly diverging by age. In the past few decades, research shows that older adults (greater than 65 years of age) have experienced a 22 to 28% reduction in hospitalization for ischemic stroke, while a steep rise of almost 44% was seen in young adult (ages 25 to 44 years) strokes and hospitalizations. 

Nasir explains, "Our results show that novel strategies are required at the population level to increase symptom awareness among young adults, where we have found a higher-risk population with substantial variations in symptom recognition." 

Important socio-demographic differences were also observed in this study, as certain groups demonstrated significantly less awareness of stroke symptoms. These included Hispanics, those not born in the U.S., and individuals with a lower level of education. Having five high-risk traits (being non-White, not born in the U.S., low income, uninsured, and having a high school education or less) increased one's odds of not knowing all five stroke symptoms by almost four times.

Commenting on the inequities revealed by the study, Nasir said, "We hope that highlighting the continued impact of current health disparities may advance focused public health strategies and educational initiatives to increase awareness of and appropriate response to stroke symptoms."

Lastly, an emergency medical services (EMS) response (i.e., calling 911 for an ambulance) was assessed in this study. Surprisingly, almost 3% of young adults said they would not call 911 if they saw someone experiencing signs of a stroke. 

Calling 911 is critically important since rapid medical attention means treatment and possible recovery from a stroke. EMS personnel are trained to start the stroke treatment protocol on the way to the hospital, and then specialized teams take over upon arrival. As Nasir explains, "Time is critical for treating stroke. The earlier people recognize symptoms, the better their chances are to reduce long-term disability from stroke."

FAST action saves lives.

In addition to familiarizing yourself with the five common stroke symptoms tested in this study, one of the most useful public health tools for remembering stroke symptoms is a mnemonic device known as FAST. The American Heart Association (AHA) and American Stroke Association both promote this tool for rapid stroke detection and action. FAST stands for:

  • Face drooping. Ask the person to smile. Is their smile uneven? You're looking for drooping or numbness in their face.
  • Arm weakness. Ask the person to raise both of their arms. You're looking to see if one arm drifts down because it's weak or numb.
  • Speech slurred. Ask the person to repeat a simple sentence (e.g., ask about the weather or when and where they were born). You're listening to hear slurred speech because they're unable to speak normally.
  • Time to call 9-1-1. If the person demonstrates any of these three symptoms above (even if you perceive that those symptoms improve), you should call 911 immediately and tell the operator you think the person is having a stroke.

Bottom line.

Noticing the signs of a stroke in yourself, a loved one, or a co-worker is the first critical step in stroke detection, so emergent medical treatment can quickly follow. Whether memorizing the five stroke symptoms or using a mnemonic device like FAST. (Remember: Face. Arms. Speech. Time to Call 911.), this knowledge will help save lives.

Ashley Jordan Ferira, Ph.D., RDN author page.
Ashley Jordan Ferira, Ph.D., RDN
mbg Vice President of Scientific Affairs

Ashley Jordan Ferira, Ph.D., RDN is Vice President of Scientific Affairs at mindbodygreen. Ashley received her B.A. in Biological Basis of Behavior from the University of Pennsylvania (along with a double minor in Nutrition and Music) and Ph.D. in Foods and Nutrition from the University of Georgia. Her research contributions span vitamin D, cardiometabolic health, bone density, and weight management. Ferira is a nutrition scientist and dietitian with experience in nutrition product innovation and development, scientific affairs, education, communications, and SEO writing for global firms, including Nature Made, Metagenics, Three Ships, and mindbodygreen.

In addition to her mindbodygreen contributions, Ferira is published in Health, Metagenics Institute, American Family Physician, The Journal of Clinical Endocrinology & Metabolism, and Osteoporosis International. She has a passion for the translation of evidence-based science into innovative and high-quality products and information that help people lead healthier lives. She is a believer in compassionate, informed, and personalized approaches to nutrition, health care, and wellness. Ashley lives in beautiful Charleston, South Carolina, where she was born and raised. Whether savoring an orchestral performance or delectable meal at a local restaurant, you will find her enjoying Charleston’s cultural and culinary arts with family and friends.