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See related article, pages 1155–1159 The 20th century witnessed marked improvements in public health and drastic reductions in mortality from common diseases of early- and midlife leading to a large and growing segment of the population over the age of 65.1 These demographic trends are expected to continue in the coming decades.1 As a result, demographers are forecasting an increase in the number of persons with common chronic conditions of aging. Among the most common, most feared, and most expensive conditions for individuals, families, and society is progressive dementia. Recent data suggest that the number of persons with dementia in the world will increase markedly over the coming decades.2,3 Accurate forecasts of the occurrence of dementia and other age-related conditions in the future are essential for proper public health planning. However, such forecasts rely on a number of assumptions in addition to census projections regarding fertility, mortality, and immigration. For example, after Alzheimer disease, stroke is generally considered to be the second most common cause of dementia.4,5 Recent data suggest that the lifetime risk of both stroke and dementia are very high.6 In addition, health care utilization costs of dementia related to stroke appears to exceed that of Alzheimer disease on a per patient basis.7,8 These data suggest that recent trends in the incidence of and survival from stroke could …

Secular Trends in Stroke Incidence and Survival, and the Occurrence of Dementia