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1 in 3 Young Adults Don't Know About Stroke Symptoms, Study Finds

MRI of a brain

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Key Takeaways

  • According to a new study, one in three people under the age of 45 don't know the signs of a stroke.
  • The five most common stroke symptoms include numbness in the face, arms and legs; trouble speaking or confusion; difficulty walking, dizziness or balance issues; trouble seeing; and severe headache.
  • The ethnic and age groups most at risk for stroke are the least likely to know the symptoms.

New research shows that nearly 30% of American adults could not recognize if someone was having a stroke. According to the study, which was published in the journal Stroke, almost 30% of adults in the United States under the age of 45 could not identify the five most common stroke symptoms.

The research came just ahead of World Stroke Day on October 29. Knowing the signs and symptoms of a stroke is vital because time is important for treatment. The earlier a stroke is diagnosed, the less likely a patient is to have long-term disability or die.

Stroke is the fifth most common cause of death in the U.S., and leaves many survivors with permanent disabilities.

While strokes are decreasing in the general population, they’ve gone up by more than 40% in the 18- to 45-year-old age category in the past few decades. Of stroke patients, 10% to 15% are younger adults.

Stroke Risk

“Stroke can happen to anyone, old or young. Even children can have strokes,” Mitchell S.V. Elkind, MD, president of the American Heart Association, tells Verywell. “We have actually seen an increase in strokes in young adults in recent years, so it is more important than ever for them to recognize the signs and symptoms of stroke."

Ekind adds that young adults might be living with older parents or grandparents, who are also at risk for a stroke. "In many communities, children live with elderly grandparents," Elkind says. "It is crucial that younger people be able to identify a stroke in an older person so they can call 911, activate emergency services and get the person to the hospital."

Khurram Nasir, MD, study author and chief of the division of cardiovascular prevention and wellness at Houston Methodist DeBakey Heart and Vascular Center in Houston, said in a statement that while medicine has made significant gains in reducing stroke severity and complications, those advances are of limited value if people do not recognize a stroke when it's happening.

5 Common Stroke Symptoms

For the study, Nassir’s team assessed responses to the 2017 National Health Interview Survey. The survey noted the five common stroke symptoms::

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

Other than most common signs and symptoms, people can also experience vertigo or dizziness if they are having a stroke—though these might be overlooked. In these cases, a person can look fine, be moving around as they typically do, and have a normal level of consciousness. “It is hard to diagnose the cause of vertigo," Elkind says. "It is common for strokes causing vertigo to go undiagnosed, unfortunately."

Michael Miller, MD, a cardiologist at University of Maryland School of Medicine, tells Verywell that while strokes can also be marked by slurred speech, that symptom might be written off if a person has been drinking alcohol or using drugs.

In younger adults, common missed stroke signs and symptoms include sudden onset of dizziness, headache, neck pain, and nausea and vomiting. 

“Unfortunately, these are symptoms also found is many other conditions that are common and not signifying a stroke. So, this is a challenge,” says Peter D. Panagos, MD, a professor of emergency medicine and neurology at Washington University School of Medicine Panagos as well as chairman of the Stroke Council for the American Heart Association and American Stroke Association.

A Lack of Awareness

The researchers looked at responses from 9,844 younger adults under age 45— a figure that represents about 107.2 million young adults in the U.S.

According to the researchers, nearly one in three respondents were not aware of all five symptoms. About 3% weren’t aware of any stroke symptoms.

Hispanic adults and adults not born in the U.S. were about twice as likely to be unaware of any of the common stroke symptoms compared to non-Hispanic White people and U.S. citizens.

Adults who earned a high school diploma or had a lower education level were nearly three times as likely to be unaware of any stroke symptom when compared to those who attained higher education. 

Almost 3% of people surveyed said they wouldn’t contact emergency medical services if they saw someone showing symptoms of a stroke—a finding that Elkind says "could be a matter of life and death."

What This Means For You

It's important for young people to know the signs of stroke in order to get treatment—whether for themselves or an older loved one—right away. The lack of knowledge can lead to delayed care and poorer recovery outcomes for stroke patients.

Low Awareness in High-Risk Groups

Elkind, who is also a neurology and epidemiology professor at Columbia University, says that he wasn’t surprised by the findings. “We know that the awareness of stroke symptoms is lower than it should be," he says. "But the fact that 30% of people do not know common stroke symptoms refers to their not knowing all 5 stroke symptoms. Only 3% of people did not know any stroke symptoms at all, so 97% of young adults knew at least one symptom."

Mitchell S.V. Elkind, MD

This lack of stroke symptom awareness may not only impact themselves but their family members.

— Mitchell S.V. Elkind, MD

Elkind adds that he's more concerned about the racial disparities in awareness. “What has me concerned though is that Hispanic people and immigrants were less likely than White people to know these symptoms, even though they are at higher risk of stroke," he says. "This indicates the need to do a better job educating people in this race-ethnic group about stroke symptoms."

"[I am] not surprised that stroke awareness is suboptimal in the U.S. population, particularly in young adults," Panagos sasy. "Since younger adults are less likely to have accumulated the common stroke and cardiovascular risk factors, they are naturally less likely to demonstrate an awareness of the signs and symptoms of stroke."

Stroke is less common in younger adults, which means that it is less likely to be recognized by healthcare providers who often consider stroke symptoms as an diagnosis for older adults.

Recognizing Stroke 

“As stroke is a leading cause of death and morbidity, it is critical for all to know the symptoms,” Daniel T. Lackland, DrPH, a professor at Medical University of South Carolina, tells Verywell. This includes making sure that the people you spend time with, such as your friends, family, and coworkers, know how to recognize a stroke.

FAST

The American Stroke Association (ASA) advocates the use of the acronym FAST to help recall the signs of a stroke and know when to call 911.

  • Face drooping
  • Arm weakness
  • Speech slurred
  • Time to call 911

Even though the acronym doesn’t include all five symptoms, Elkind says that it captures the most important symptoms and is easy to remember. 

“If in doubt, it is always recommended to call 911,” says Panganos." The EMS system is trained on stroke recognition, early management and knows exactly where to transport a potential stroke patient in their community.” 

Michael Miller, MD

It boggles the mind that such common problems and preventive strategies are not discussed.

— Michael Miller, MD

Panganos adds that the best stroke care is often provided at certified stroke centers. "EMS providers know exactly where a particular patient should be transported in order to receive the fastest and most appropriate care," he says.

Miller says that stroke education should start earlier—it could be easily incorporated into the health or physical education curriculum for high school students.

"Signs and symptoms of heart disease and stroke can be reviewed," Miller says. "High school students would then be more aware of these potential issues should they occur in their relatives, parents or grandparents in addition to risk factors that help to prevent their occurrence. It boggles the mind that such common problems and preventive strategies are not discussed."

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