Stroke - prevalence, trends, and regional patterns in Germany. An analysis based on routine data from the statutory health insurance.

Background: As part of the German Burden of Disease Study, population-based prevalences of important diseases are estimated. This allows regional patterns and temporal trends to be identified. Methods: The 10-year prevalence of stroke in the population was estimated cross-sectionally for the years 2017 to 2022 at the level of the Spatial Planning Regions using routine data of persons insured in the statutory health insurance AOK, adjusted for age, sex and morbidity (administrative 10-year prevalence). Results: In 2022, 1.4 % of the population in Germany was living with the consequences of a stroke that had occurred up to 10 years ago (women: 1.3 %, men: 1.6 %). Prevalence increases continuously with age - from 1.2 % (women) and 2.3 % (men) in the 60 - 64 age group to 8.3 % and 9.8 % in the 90 - 94 age group. Over time, age-standardised prevalence has remained largely stable since 2017. The age-standardised regional distribution shows a variation of up to 60 % between regions. Low values (below 1.1 %) are found mainly in southern German regions, while the highest values (above 1.5 %) without a clear pattern are found, for example, in the Emscher-Lippe, Saar, and southern Thuringia regions. Conclusions: Measured in terms of administrative 10-year prevalence, the significance of stroke for public health remains high, not least because of the high mortality rate, with high prevalence rates continuing to be achieved, especially in older age groups. In order to achieve a decline, more low-threshold, evidence-based prevention services are needed in addition to targeted interventions.