Epidemiology of cerebrovascular disease in the elderly in East Asia

Cerebrovascular disease (CVD) is one of the leading causes of mortality, and is also the most common cause of physical and mental disability in the elderly worldwide, particularly East Asian populations. CVD mortality accounts for 10–16% of total deaths and has declined moderately since the mid-1960s in East Asia. However, with increased aging populations, no alteration of age-specific stroke incidence, Westernization of lifestyle, and socioeconomic alteration, the burden of CVD in the elderly in East Asia may still escalate in the forthcoming decades. There are prominent race–ethnic differences in stroke types between East Asian and Caucasian populations. The proportions of cerebral hemorrhage, small artery lacunar infarct, and intracranial atherosclerosis are more common in East Asian populations than Caucasians. Environmental and genetic factors may account for the race–ethnic differences and trends of stroke types. Hypertension is still the major risk factor for CVD in East Asia. Control of blood pressure in the population level should be the important strategy for the prevention of CVD. With aging populations, CVD-related dementia becomes more and more critical, particularly in East Asia. Urbanization, industrialization, and lifestyle are altering in this area, thus, monitoring the impact of these changes on CVD risks is essential to enable the implementation of appropriate strategies towards better prevention of CVD.