[Morbidity Compression in Stroke: Longitudinal Analyses on Changes in the Incidence of Stroke]. / Morbiditätskompression bei Schlaganfall? Langzeitanalysen zur Veränderung des Auftretens von Schlaganfall.

ABSTRACT

According to Fries, morbidity compression occurs if age at onset of disease/disability and age at death increase. Morbidity compression is also present if disease/disability rates decrease to the same or to a larger extent than standardized death rates. In all cases, healthy lifetime is gained. Not many studies on morbidity compression are available, and only a small number of them refer to specific diseases. Stroke is used as an example for examining whether morbidity compression has occurred over an observation period of 9 years. METHODS: The study was based on pseudonymized data of a statutory health insurance covering 2006-2014 with 2 million insured per year. Analyses were performed for all types of stroke, separately for cerebral infarction, and for hemorrhages (ICD 10 I60-I62). Calculations were performed by means of survival analyses and with multiple regression. RESULTS: In women and in men, rates decreased only for hemorrhagic strokes, while changes of onset age were difficult to interpret. Standardized death rates dropped only in males. CONCLUSIONS: Evidence in favor of morbidity compression was found only for decreasing rates of hemorrhagic strokes. It has, however, to be kept in mind that the findings refer to a single disease occurring relatively late in the life course. Comprehensive assessments of morbidity compression are only possible taking into consideration a broader spectrum of diseases.