Stroke In The Older Person

Stroke is a condition that predominantly affects older people, often leading to death, disability and dependency as well as occupancy of hospital and nursing-home beds. Older stroke patients are similar in many ways to their younger counterparts, but at the same time exhibit several key differences. Their outcome and care are complicated by delayed diagnosis, polypharmacy, difficult rehabilitation, ageism, false assumptions of poor outcome, multiple co-morbidity, social issues including implications for independent living, ethical dilemmas, and many others. The proportion of older people is increasing every day and with it the burden of disease and disability. The implications this has for health services are immense, especially for long-term conditions. Despite this there is limited literature available to clinicians on stroke with a particular focus on this age group. Traversing the whole stroke pathway, Stroke in the Older Person brings together key discussions on every aspect of the disease as it affects the older person, including its general aspects and those very specific to the older populations. All chapters are written by highly experienced clinicians that offer up-to-date evidence-based information as well as practical tips to promote excellent, empathetic care to older patients. Over 30 chapters, this resource addresses the epidemiology, aetio-pathogenesis, clinical presentation, diagnostic work-up (including imaging), primary and secondary prevention, and rehabilitation of older people. There is a special focus on intracerebral haemorrhage, carotid re-vascularisation, transient ischaemic attack, cognitive impairment, research, ethical and moral dilemmas including DNAR, advanced directives and end-of-life care.