Novel Risk Factors for TIA and Stroke in Young Adults

Purpose: From 1993 to 2005 the incidence of stroke in older adults (ages 55-84) substantially decreased while in younger adults (ages 20-44) the incidence more than doubled. Traditional risk factors for stroke have been well documented in older adults such as hypertension, diabetes and obesity. Fewer studies explore transient ischemic attack (TIA)/stroke risks in young adults. Thus, it is clinically relevant to examine novel risk factors that may be unique to young adults. To better understand the increasing incidence for stroke in this population, we examined physical, psychological, and cognitive indices as novel risk factors for TIA and stroke in young adults. Hypothesis: Those identified as moderate/high risk for TIA/Stroke will have higher truncal body fat percent and waist-to-hip ratio (WHR) and will perform poorer on cognitive and stress tests compared to no/low risk. Methods: Men and women ages 18-45 of all race/ethnic backgrounds were eligible to participate in this prospective, cross-sectional, pilot study. Demographic data, WHR, body fat percent, personal and family history of chronic illness, TIA/stroke, etc. were collected. Assessments included the Perceived Stress Scale, Coping Self-efficacy Scale, and the Rey-Osterrieth Complex Test. Descriptive statistics, frequency distributions, independent sample t-tests, ANOVA, and regression modeling, were used as appropriate. All analyses were conducted using a 95% confidence level and an alpha level of 0.05 to determine statistical significance. Results: A total of 50 subjects participated in this study (n=50). Each subject was grouped as no/low risk (NL) or moderate/high risk (MH) based on their personal + family medical history + total body fat percent. The MH group had significantly higher BMI (p = 0.03), higher body fat percent (p = 0.001), and higher truncal body fat distribution (p=0.001). MH subjects had more difficulty with cognitive-based coping skills, higher perceived stress, and performed worse on the Rey-Osterrieth test than the NL group. Conclusion: These preliminary data suggest that those who have a moderate-to-high TIA/stroke risk profile have higher stress levels, less memory recall, and reduced cognitive-based coping skills. The results inform researchers about the need to further explore these novel risks factors in a larger controlled study. Future studies are needed to identify young adults who are at risk of TIA/stroke to reduce the incidence rate in this population.