DÄ internationalArchive48/2008The Projected Burden of Stroke in the German Federal State of Hesse up to the Year 2050: In Reply

Correspondence

The Projected Burden of Stroke in the German Federal State of Hesse up to the Year 2050: In Reply

Dtsch Arztebl Int 2008; 105(48): 844. DOI: 10.3238/arztebl.2008.0844b

Neumann-Haefelin, C F T

LNSLNS Professor Herrmann makes an important point. In our article, we assumed stable, age specific stroke incidence rates for the future. We based our calculations of the reported increase in stroke rates to 2050 on demographic trends without taking any further assumptions into account. However, as Professor Herrmann points out, assuming stable incidence rates may not be justified since "the fact that people are living longer in our society is partly due to a reduction in morbidity" (key word healthy ageing); this would mean we have overestimated future stroke rates.

However, the literature thus far is showing no clear decrease in stroke rates, something that we went into in great detail in our discussion section. In view of the literature published worldwide in long term trends in stroke incidence and "internal" comparison of our data (2005) with data from Erlangen's stroke registry from the early 1990s, we think that our assumption of mainly stable incidence rates is justified. Additionally, other factors influence the ageing society (not only the reduction in morbidity)-for example, people born in years with a high birth rate entering older age categories. In any case, continuing documentation in the context of quality assurance of stroke therapy in Hesse should put us in a position whereby we are able to regularly update and adapt our findings. DOI: 10.3238/arztebl.2008.0844b

Dr. med. Christian Förch
Prof. Dr. med. Tobias Neumann-Haefelin
Klinik für Neurologie
Zentrum der Neurologie und Neurochirurgie
Schleusenweg 2–16
60528 Frankfurt, Germany
tnh@rz.uni-frankfurt.de

Conflict of interest statement
The authors of both the letter and of the reply declare that no conflict of interest exists according to the guidelines of the International Committee of Medical Journal Editors.