Stroke Is Increasing in Younger Adults and Yes, It’s Scary

Let’s cut to the chase: If you’re a millennial or younger Gen X-er, you probably aren’t thinking about stroke — after all, it only happens to old people … right? 

While that’s generally true, one in seven strokes happens in people under age 50. Most of these are ischemic strokes, when blood flow to the brain is blocked, but research from 2022 shows that rarer intracerebral hemorrhagic strokes are increasing among adults aged 18 to 64 relative to rates among adults over age 75. This type of stroke happens when a brain artery leaks or bursts, and it is deadlier and more likely to cause significant disability. 

Disturbing, for sure. So, what does this mean for you?

More reasons to take stroke seriously 

Data spanning from 1990 through 2019 showed that stroke is the second-leading cause of death worldwide and the third-leading cause of death and disability. 

In Washington state, several counties have high rates of death from stroke: Pierce, Wahkiakum, Cowlitz and Clark counties in the western part of the state and Franklin, Adams and Columbia counties in the eastern part of the state. 

There are many things that can cause a stroke, but having untreated high blood pressure, atrial fibrillation or high cholesterol can increase stroke risk, as can having a chronic condition like diabetes or heart disease.

Memorize this acronym so you know how to recognize stroke symptoms if you see or experience them (and to seek medical care right away):  

F – Face drooping 

A – Arm weakness 

S – Slurred speech 

T – Time to call 911 

What causes stroke in millennials?  

What if you had the power to change your future? To know that there's the possibility that something bad will happen to you, but that you have the power to prevent it? 

When it comes to health, in some ways, you can, because the way you treat your body now affects how you age.  

“Stroke risk factors like diabetes, high blood pressure, unhealthy diet and little physical activity start earlier than we ever realized, sometimes even in childhood. If people can make sustained, healthy choices throughout life, they can have a significant impact on their risk of stroke, even though strokes won’t happen for many decades,” says Dr. Gregory Roth, a cardiologist at the UW Medicine Heart Institute and a researcher at the Institute for Health Metrics and Evaluation (IHME).

We’re not trying to shame anyone or tell you not to eat pizza or binge Netflix. Doing those things sometimes is totally fine (and fun). But if that’s what most of your days look like — or if you’re “too busy” to exercise — well, those aren’t helpful habits to form.

Sometimes there’s a sense that, if you’re young and relatively healthy, you can get away with habits like that. But that’s not necessarily true, Roth says. 

“These things are becoming a problem among people in their 20s but are not identified as a problem until they’re older,” he says. “Stroke is really a disease that’s lurking, waiting for people later in life,” Roth says. 

Why it’s so hard to change your habits 

Maybe you already knew that the decisions you make now will affect your later life. So … why aren’t you making healthier ones? (Aside from barriers and constraints in your life that affect what choices you can make, of course.) 

Don’t worry, it’s not just you. Psychologists have scientifically confirmed that just because we know something is good for us doesn’t mean we’ll do it. Changing habits is hard.

They’ve even developed behavior models to better understand the phenomenon. One called the health belief model shows that someone must feel like they’re susceptible to a threat to change their behavior.

It may seem obvious, but outlining behaviors in a scientific way helps psychologists understand why we behave the way we do — and what strategies will be most successful if we want to change our behavior. 

According to Brenna Renn, an affiliate researcher at the University of Washington Department of Psychiatry and Behavioral Sciences, there are several barriers that keep people from making healthy behavioral changes. 

First, there’s social pressure. Unless most of your friends are gym rats, yogis and meal-preppers, it’s likely your peers are influencing you to binge-watch shows and order takeout because that’s what they do, too. 

Plus, when you have so much competing for your time — your job, your side hustle, your pets, your houseplants — the more immediately rewarding thing to do is to relax, and most of us don’t count working out as relaxing. 

Confidence, too, plays a big role, says Renn. 

“If someone hasn’t gone to the gym before, they might not have the confidence or experience to believe that they’ll be able to do it. People who exercise a lot have a history of knowing that if they can just get there, the exercise will take care of itself,” she says. 

Still, there are things you can do to encourage habit change. 

Consider what’s holding you back 

First, recognize why you order pizza instead of cooking. Don’t just write yourself off as being lazy. Maybe you have a stressful job and use eating pizza to relax and get some downtime. And maybe you try to spend an hour with your kid each night after work, meaning you’re super hungry after and don’t want to wait for food to cook.  

Understanding that your habits have their own purposes can help you be more compassionate with yourself and approach your decision to change from a healthier, less shaming place.

Think about your motivations 

The next step toward making healthy behavior changes is considering what would motivate you to actually do them. And, clearly, thinking about how exercising more will lower your stroke risk in 30 years doesn’t count.  

“Make your motivations more immediately relevant,” says Patrick Raue, a clinical psychologist at UW Medical Center – Roosevelt and an expert in motivational interviewing, a type of therapy that helps people tap into their motivation to change their lives. 

Motivations that are relevant to you in the present could be things like exercising for your emotional and physical well-being, saving money by cooking at home more or by quitting vaping. 

Whatever you decide to focus on, make that the main reason you decide to make the change, and supplement that with the idea that you’re also helping your future self prevent disease. 

Start small and don’t be hard on yourself 

Additional tips from Renn and Raue include starting small so you’re setting yourself up for success instead of failure; using peer support by enlisting a friend to go along with you and help hold you accountable; and scheduling reminders in your phone so you won’t forget what you wanted to do. 

And, at the end of the day, be proud of what you did accomplish, even if it wasn’t as much as you’d hoped. Recognize that you’ll have some days that are more successful than others, and that’s OK. 

“Realize that motivation is a fluctuating state; today might be different from the next day,” Raue says. 

So even if you still binge watch or eat pizza several nights a week but add in a day or two where you go to the gym, that’s progress. Your future self will thank you. 

Editor's note: This article was originally published on February 25, 2019. It has been reviewed and updated with new info.