Strokes have nearly doubled among younger adults, and scientists aren't sure why
Strokes are becoming alarmingly common among younger adults, with rates nearly doubling among people ages 20 to 54 over nearly three decades. Researchers found that blocked blood vessels in the brain accounted for much of the increase, while high blood pressure, diabetes, and substance use also became more common among younger stroke patients. Although survival rates have improved, more young adults may now face the…
Key points
- Stroke rates among adults aged 20 to 54 nearly doubled between 1993-1994 and 2020 in Greater Cincinnati and Northern Kentucky.
- Ischemic strokes drove most of the increase, while bleeding strokes showed no comparable rise.
- Substance use among younger stroke patients rose from 4.6% to 40.2%, but the study could not establish causation.
A new study has found that strokes nearly doubled among younger adults over almost three decades, challenging the belief that strokes mainly affect older people. Researchers examined medical data from the Greater Cincinnati and Northern Kentucky region between 1993 and 2020, identifying 2,076 adults aged 20 to 54 who had their first stroke.
The findings were published September 23, 2026, in Neurology, the medical journal of the American Academy of Neurology. The stroke rate rose from 33.9 cases per 100,000 person-years in 1993-1994 to 62.2 in 2020, an increase of about 83%.
What drove the increase
Ischemic strokes, caused by a blocked blood vessel in the brain, accounted for most of the rise. Their rate among younger adults climbed from 23.8 cases per 100,000 person-years in 1993-1994 to 47.3 in 2020. The study found no similar increases in intracerebral hemorrhage or subarachnoid hemorrhage, two types of bleeding strokes.
Additional research is needed to better understand what is driving these trends and how they can be reversed.
— Emily R. Fisher, MD
Risk factors and survival
High blood pressure, diabetes, atrial fibrillation, and substance use became more common among younger adults who had strokes. Substance use rose from 4.6% to 40.2%, with much of the increase linked to marijuana. However, the study could not determine whether these trends caused the higher stroke rates, because it lacked comparable data from people without strokes.
Survival improved: the proportion of patients who died within 30 days fell from 11.7% in 1993-1994 to 9.4% in 2020, with the biggest gains for bleeding strokes. Still, survivors may face lasting problems with movement, speech, memory, or other abilities. The researchers said more work is needed to understand and reverse the trend.
