Prevention and management of stroke in very elderly patients.

As the average human lifespan extends and medical care improves, there are more individuals above the age of 80 years who have a high quality of life. However, these very elderly individuals are particularly susceptible to stroke. Identifying ways to optimise the treatment and prevention of acute stroke in these much older people will increasingly be a priority for health-care providers, research funding agencies, and policy makers in years to come. Despite substantial advances in stroke research, with several therapeutic drugs being able to enhance clinical outcomes in people with stroke or who are at risk of stroke, the very elderly seem to receive fewer vascular protection interventions that have been shown to be effective in younger individuals. Although there has been an under-representation of the very elderly in studies of stroke therapy, these treatments might be of benefit to this group of patients. Indeed, emerging data indicate that the use of several of these therapies in routine clinical practice in the very elderly can be effective.