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Stroke Therapeutics in the Care of Older Persons

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Optimizing Pharmacotherapy in Older Patients

Part of the book series: Practical Issues in Geriatrics ((PIG))

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Abstract

Stroke is one of the main causes of long-term disability and death worldwide. With an ageing population and the incidence of stroke rising with age, therapeutics in stroke management has come into sharper focus in recent years. Recognition and early diagnosis can be challenging in older patients due to atypical presentations. Multimodality brain imaging is now widely accessible and has transformed hyperacute treatment of ischaemic stroke, which accounts for the majority of all strokes. Owing to the introduction of reperfusion therapy with thrombolysis and mechanical thrombectomy, reduction in morbidity and mortality has been seen in patients of all ages including the oldest old. Furthermore, anticoagulation in atrial fibrillation and revascularisation in atherosclerotic carotid disease have been associated with significant reductions in ischaemic stroke and transient ischaemic attacks. Optimisation of modifiable risk factors such as hypertension, hyperlipidaemia and diabetes is crucial for both haemorrhagic and ischaemic stroke prevention. Patient-centred and individualised stroke care delivered by an organised specialist multidisciplinary team remains the cornerstone of stroke management. Ongoing research continues in the arena of stroke therapeutics in the older person.

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Authors and Affiliations

  1. University Hospitals Sussex NHS Foundation Trust, Brighton, East Sussex, UK

    A. Bahk, F. A. Kirkham, Y. T. Ng & Chakravarthi Rajkumar

  2. Department of Medicine, Brighton and Sussex Medical School, University of Sussex, Brighton, UK

    Chakravarthi Rajkumar

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  1. A. Bahk
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  2. F. A. Kirkham
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  3. Y. T. Ng
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  4. Chakravarthi Rajkumar
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Correspondence to Chakravarthi Rajkumar .

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Editors and Affiliations

  1. Geriatric, Geriatric Admissions and Aging Research Center, IRCCS INRCA, Ancona, Italy

    Antonio Cherubini

  2. Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia

    Arduino A. Mangoni

  3. Department of Medicine, and Department of Geriatric Medicine, Cork University Hospital, Cork, Ireland

    Denis O’Mahony

  4. Section of Geriatrics, Department of Internal Medicine and Paediatrics, Ghent University, Gent, Belgium

    Mirko Petrovic

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Bahk, A., Kirkham, F.A., Ng, Y.T., Rajkumar, C. (2023). Stroke Therapeutics in the Care of Older Persons. In: Cherubini, A., Mangoni, A.A., O’Mahony, D., Petrovic, M. (eds) Optimizing Pharmacotherapy in Older Patients. Practical Issues in Geriatrics. Springer, Cham. https://doi.org/10.1007/978-3-031-28061-0_24

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