Highlights:
MINNEAPOLIS — Stroke is becoming more common among younger adults, according to a study published September 23, 2026, in Neurology ® , the medical journal of the American Academy of Neurology . Researchers found that strokes among adults ages 20 to 54 nearly doubled over nearly three decades, even as short-term survival after stroke improved.
“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 Emily R. Fisher, MD, of the University of Cincinnati. “At the same time, more people are surviving these strokes, which means more younger adults may be living with the long-term effects of stroke.”
The study looked at strokes in the Greater Cincinnati and Northern Kentucky region from 1993 through 2020. Researchers identified 2,076 first-ever strokes among adults ages 20 to 54.
Researchers found that the rate of strokes among younger adults increased from 33.9 cases per 100,000 person-years in 1993-1994 to 62.2 cases per 100,000 person-years in 2020.
The increase appeared to be driven by ischemic stroke, which occurs when blood flow to part of the brain is blocked. The ischemic stroke rate rose from 23.8 cases per 100,000 person-years in 1993-1994 to 47.3 cases per 100,000 person-years in 2020. Researchers did not find similar increases for other types of stroke such as intracerebral hemorrhage, a bleeding stroke within the brain, or subarachnoid hemorrhage, a bleeding stroke around the brain.
Researchers found that some health problems became more common over time among people who had a stroke. There were increases in high blood pressure, diabetes, atrial fibrillation and substance use among younger adults who had stroke. Substance use among younger adults with stroke increased from 4.6% in 1993-1994 to 40.2% in 2020, with much of the increase reflecting marijuana use.
Researchers also looked at 30-day death rates after stroke. After adjusting for age, race and sex, researchers found a slight decline over time, from 11.7% in 1993-1994 to 9.4% in 2020. Improvements were largely seen among people with intracerebral hemorrhage and subarachnoid hemorrhage.
“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.”
A limitation of the study was that researchers did not have comparable information from people without stroke, so they could not determine whether observed trends in risk factors explain the increase in stroke rates.
The study was supported by the Greater Cincinnati/Northern Kentucky Stroke Study.
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The American Academy of Neurology is the leading voice in brain health. As the world’s largest association of neurologists and neuroscience professionals with more than 44,000 members, the AAN provides access to the latest news, science and research affecting neurology for patients, caregivers, physicians and professionals alike. The AAN’s mission is to enhance member career fulfillment and promote brain health for all. A neurologist is a doctor who specializes in the diagnosis, care and treatment of brain, spinal cord and nervous system diseases such as Alzheimer's disease, stroke, concussion, epilepsy, Parkinson's disease, multiple sclerosis, headache and migraine.
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Neurology