The number of acute cerebrovascular events in Israel: A forecast until 2040

Background: Acute cerebrovascular event is one of the leading causes of death in Israel and is the primary cause of neurological disability in adults. Although some evidence indicates that the incidence rate of acute cerebrovascular events in developed countries is stable or has been decreasing over the past decades, the number of events is expected to increase in these countries due to projected changes in size and composition of the population. The purpose of this study was to provide a forecast of the number of acute cerebrovascular events in Israel for the coming decades. Methods: We used data from the National Stroke Registry at the Israel Center for Disease Control and data from the long-term population forecasts of the Israeli Central Bureau of Statistics. We generated forecasts of the annual number of acute cerebrovascular events based on the mean annual incidence rates during 2014-2016 within population subgroups defined by gender, age, and ethnicity, and on the projected population size of these subgroups for 2015-2040. The forecasts were generated for various assumptions as to trends in the incidence rate and for alternatives as to the projected population growth. Results: Based on the intermediate population growth alternative, the annual number of acute cerebrovascular events is expected to increase from 18,400 to 38,500, 34,800 or 26,400 events, assuming constant annual incidence rates, decreasing annual incidence rates at a rate of 2% every 5 years, or decreasing annual incidence rates at a rate of 7.25% every 5 years, respectively. Whereas, presently, events affecting Arab patients account for 15% of acute cerebrovascular events and events affecting patients over 80 account for 33% of acute cerebrovascular events, by 2040 events affecting Arab patients will account for more than 21% of the events and events affecting patients over 80 will account for 42% of the events. Conclusions: In view of the expected increase in the number of acute cerebrovascular events and the changes in the demographic composition of adults suffering from such events, and in order to allow for optimal care and equity, it is imperative to evaluate the preparedness of care provision and the geographical deployment of treatment services in the short and long term.