University of Cincinnati study finds stroke rate nearly doubled among younger adults

A new University of Cincinnati study found that the stroke rate among younger adults nearly doubled over nearly three decades, raising concerns about the growing burden of stroke among people traditionally considered at lower risk.

Researchers analyzed data from the Greater Cincinnati/Northern Kentucky Stroke Study, which has tracked stroke patterns in the region since 1993. 

The study focused on adults ages 20 to 54 and examined stroke trends through 2020.

The study was published online on Wednesday, Sept. 23.

Stroke rate nearly doubled among adults ages 20 to 54

Researchers identified 2,076 first-ever strokes among adults ages 20 to 54 during the study periods.

The stroke incidence rate increased from 33.88 cases per 100,000 person-years in 1993-94 to 63.73 cases per 100,000 person-years in 2020.

The increase was primarily associated with ischemic stroke, the most common type of stroke. Ischemic strokes occur when a blood clot or another blockage prevents blood from reaching part of the brain.

Researchers did not find a similar increase in intracerebral hemorrhage or subarachnoid hemorrhage during the study period.

“While stroke has traditionally been considered a disease of older adults, our findings show that stroke is becoming increasingly common in younger adults,” said study author Dr. Emily Fisher, a vascular neurology fellow in UC’s Department of Neurology and Rehabilitation Medicine.

Health risk factors also increased

The researchers found that several health conditions became more common among younger adults who experienced strokes over the study period.

Those conditions included high blood pressure, diabetes and atrial fibrillation, a type of irregular heart rhythm that can increase the risk of stroke.

Substance use also increased substantially among younger adults who had a stroke.

The study found that substance use increased from 4.6% in 1993-94 to 40.2% in 2020. Researchers said much of the increase reflected marijuana use.

However, the study does not establish that substance use or any individual health condition caused the rise in stroke incidence.

Instead, the findings show that these factors became more common alongside the increase in strokes. Researchers said additional studies are needed to better understand what is driving the trend.

More younger adults survived their strokes

While stroke became more common among younger adults, the study found that the 30-day death rate after stroke declined slightly.

The adjusted 30-day case-fatality rate fell from 11.7% in 1993-94 to 9.4% in 2020.

Researchers said the combination of increasing stroke incidence and improving short-term survival means more younger adults may be living with the long-term effects of stroke.

“Our findings highlight the importance of identifying and managing stroke risk factors early in adulthood,” Fisher said. “Additional research is needed to better understand what is driving these trends and how they can be reversed.”

Why the Cincinnati study matters

The Greater Cincinnati/Northern Kentucky Stroke Study provides researchers with decades of population-based data on stroke in the region.

The latest findings show a different trend between younger and older adults. Stroke incidence increased among adults ages 20 to 54 while incidence among older adults declined during the study period.

The researchers said the findings underscore the importance of recognizing stroke as a potential health concern in younger adults and identifying risk factors earlier in life.

The study’s most recent data are from 2020, meaning the research does not establish the current stroke rate among younger adults in the Cincinnati region in 2026.