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Strokes aren't just an elderly issue: Experts warn of rise in cases among younger people in Singapore
Doctors warn that stroke cases in younger patients are on the rise in Singapore.
PHOTO: Unsplash/Robina Weermeijer
PUBLISHED ONOctober 25, 2025 1:53 PM
BYCarol Ong
Think you're too young to suffer a stroke?
According to experts and statistics, the life-threatening condition often thought to affect only the elderly might actually be a cause for concern among even the younger demographic.
While the mean age of stroke in Singapore is 65 years old according to the Singapore National Stroke Association, doctors are now observing an increased number of stroke cases in younger Singaporeans.
Referencing Singapore Stroke Registry's annual report from 2021, Dr Benjamin Tan, consultant for the division of neurology and department of medicine at National University Hospital (NUH), told AsiaOne that the incidence rate of stroke among those aged 40 to 49 "leapt by over 30 per cent over a decade".
According to the report, there was a "significant rise" in incidence rates for all age groups, with the exception of those aged 15 to 29.
And while many other conditions like prostate cancer are now becoming more prominent in younger patients due to better awareness and early diagnoses, Dr Tan said that this is only "part of" the reason for the rise in stroke incidences, and "much of it is due to a genuine increase" in underlying risk factors.
These include high blood pressure, high cholesterol, diabetes and smoking.
Citing a study published on the National Library of Medicine (NIH), Dr Wee Chee Keong, neurologist at Capernaum Neurology, echoed that smoking and diabetes in the younger demographic may contribute to some of these occurrences.
NUH's Dr Tan also explained that almost 60 per cent of young ischemic stroke patients had either atherosclerosis (clogged or damaged arteries), or the risk factors that lead to it.
"Put simply, the same 'wear and tear' on blood vessels that we expect to see in older adults is now showing up in people of younger ages with stroke,” said the neurologist.
Modifiable risk factors aside, genetics also come into play for early stroke cases.
According to Dr Tan, they play a bigger role in young stroke patients than in older adults.
An example of this is familial hyperlipidemia, a condition in which people inherit genes that cause very high cholesterol from a young age.
People with familial hyperlipidemia can have high levels of LDL (low-density lipoprotein), or "bad cholesterol" even with healthy diets and exercise. This in turn accelerates plaque build-up in blood vessels and increases the risk of stroke.
Other rarer single-gene disorders account for roughly three to five per cent of strokes in young adults.
Beyond these conditions, Dr Tan also stated that many young patients carry multiple "small genetic variants that collectively raise stroke risk".
"That being said, genes are not destiny," explained the neurologist, adding that even with a strong family history, modifiable factors like lifestyle changes and early treatment "can dramatically reduce risk".
Said Dr Tan: "If a family member had a stroke at a young age, it’s important to get screened early for cardiovascular risk factors that can be managed effectively once detected."
Types of strokes
There are mainly two types of strokes: ischemic stroke and haemorrhagic stroke — the former being one that affects the younger demographic more.Capernaum Neurology's Dr Wee stated that "most strokes are ischemic", taking up 80 per cent of cases, while haemorrhagic strokes are at 20 per cent.
But what exactly is the difference between the two?
According to Dr Tan, ischemic stroke occurs when a blood vessel supplying blood to the brain is blocked, usually by a clot.
It’s also the most common type across all age groups.
Haemorrhagic stroke, on the other hand, occurs when a blood vessel bursts, causing bleeding in the brain.
They are also "relatively more common" in younger patients than in older adults despite ischemic strokes being the "most frequent cause of stroke".
Importance of identifying stroke symptoms FAST
Time is of the essence when it comes to stroke, and it’s important to be able to identify the symptoms swiftly so as to not delay treatment.Speaking from experience, NUH's Dr Tan shared that he had seen patients from as young as 20s and 30s "wait hours or even days" before seeking medical attention because they assumed that their stroke symptoms were simply due to migraines or fatigue.
"Every minute counts with stroke," he stressed.
One way to identify stroke symptoms is the FAST test — which stands for Face drooping, Arm weakness, Speech difficulty and Time to call 995.
According to HealthHub, any one of the mentioned symptoms that come on suddenly can indicate a stroke.
Urged Dr Tan: "Everyone needs to know the FAST warning signs: Face drooping, Arm weakness, Speech difficulty and Time to call 995. The key message is: Do not wait to see if symptoms pass and seek emergency care immediately. Even mild symptoms can signal a serious stroke, and some cases may be treatable with clot-busting medication, clot retrieval procedure or surgery."
How to minimise risk of stroke
While stroke can be debilitating, doctors say that it’s not all doom and gloom."The good news is that many strokes are preventable, and the earlier you start, the better," said Dr Tan.
And for young adults, the neurologist said that "prevention means being proactive rather than reactive".
That means thinking about your vascular health now rather than later by regularly checking blood pressure, cholesterol and blood sugar levels according to national screening guidelines, "even if you feel fine".
The neurologist highlighted that high blood pressure, in particular, is often called the "silent killer".
This is because it usually causes no symptoms until serious damage occurs.
Lifestyle habits formed in youth also having a "compounding effect" on health according to Dr Tan.
For those who smoke, the neurologist emphasises that quitting is critical, as it increases stroke risk at any age.
Singapore's "vibrant" food culture also means that certain foods may be high in salt, sugar and unhealthy fats, and people should aim for more vegetables, whole grains and lean proteins, as well as portion-control and limit processed foods.
Dr Tan also advised that staying physically active with at least 150 minutes of moderate exercise per week can help minimise stroke risk.
"This does not require a gym. Brisk walking, cycling or swimming all count," he said.
Managing stress and getting enough sleep are also crucial as chronic stress and poor sleep can raise blood pressure and increase risk for stroke.
'Dangerous misconceptions' of stroke
"Many young adults think they are 'too young for a stroke'. That is a dangerous misconception. Delaying treatment can have serious consequences," warned Dr Tan.Dr Wee agrees, stating that the "greatest risk" for younger individuals is "not recognising they have a stroke when it occurs".
"Many believe that [stroke] is a disease of older people and that they are invulnerable. This results in delayed treatment," he stated, emphasising that stroke treatment is most effective and "only works" in the first hours after onset to prevent the "dreaded disabilities" the condition causes.
Warned the neurologist: "Delay in seeking help by a couple of hours could mean these treatments are no longer effective and even harmful if attempted. Regardless of age, if a person looks like they are having a stroke (using the FAST test), call 995 and get to an emergency hospital ASAP."
