Stroke in young adults, silent symptoms and late diagnosis: India's growing brain health challenge

Stroke is no longer a disease associated only with old age. Neurologists warn that an increasing number of Indians in their 30s and 40s are suffering strokes, while neurological disorders such as dementia, Parkinson's disease and epilepsy are emerging as a major public health challenge amid an ageing population, rising lifestyle diseases and delayed diagnosis.

On World Brain Day, specialists called for greater public awareness, quicker referrals and improved access to neurological care, saying early intervention can prevent disability and save lives.

According to the World Health Organisation, neurological disorders are among the leading causes of disability worldwide. In India, doctors say changing lifestyles, uncontrolled hypertension and diabetes, coupled with inadequate access to specialist care are contributing to a growing neurological disease burden.

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Stroke No Longer Limited To The Elderly

Dr Madhukar Bhardwaj, Director and Head of Neurology at Aakash Healthcare, said neurological disorders are no longer affecting only a small section of the population but have become one of India's most pressing healthcare challenges.

He pointed to the worrying rise in stroke among younger adults, driven by uncontrolled hypertension, diabetes, obesity, smoking, chronic stress, sedentary lifestyles and poor sleep. Many neurological disorders, including stroke, epilepsy, Parkinson's disease and memory disorders, progress silently before obvious symptoms appear, making early diagnosis critical for better outcomes.

Adding perspective to the growing burden, Dr Geeta Chopra, Chief of Lab – North India Operations, Metropolis Healthcare Ltd, said stroke is now the fourth leading cause of death and the fifth leading cause of disability in India. She explained that strokes occur when blood supply to the brain is interrupted, either due to a blocked artery (ischaemic stroke) or a ruptured blood vessel (haemorrhagic stroke).

Dr Chopra said hypertension, diabetes, atrial fibrillation, high cholesterol, smoking and alcohol abuse remain among the biggest modifiable risk factors. People with diabetes face nearly three times the risk of stroke compared with the general population, while uncontrolled blood sugar and blood pressure can significantly worsen outcomes.

Dr Rajul Aggarwal, Director-Neurology at Sri Balaji Action Medical Institute, said symptoms such as persistent headaches, weakness on one side of the body, facial drooping, difficulty speaking, seizures, balance problems or unusual behaviour require immediate medical evaluation. In stroke, every minute counts because delayed treatment causes irreversible brain damage.

Recognising Symptoms Early Can Save Lives

Experts said delayed diagnosis remains one of the biggest reasons for poor neurological outcomes.

Dr Chopra urged people to remember the BE FAST warning signs of stroke—Balance problems, changes in Eyesight, Face drooping, Arm weakness and Speech difficulty. Any of these symptoms require immediate emergency care, she said, adding that the first hour after a stroke is considered the "golden hour", when rapid MRI imaging and treatment offer the best chance of recovery.

Dr Sonia Lal Gupta, Senior Consultant Neurologist and Joint Managing Director at Metro Group of Hospitals, said many neurological conditions can be effectively managed if detected early. However, patients frequently ignore symptoms, delay visiting specialists or rely on alternative remedies.

She stressed that awareness must be backed by timely diagnosis, specialist consultations, emergency care, rehabilitation facilities and stronger referral systems linking general physicians with neurology centres. While telemedicine can improve access in smaller towns, it should complement rather than replace physical clinical evaluation.

Dr Mukund Agrawal, Associate Consultant-Neurology at Regency Hospital (Gorakhpur) said patients from rural areas often travel long distances for neurological care. In emergencies such as stroke, seizures and brain infections, these delays can prove fatal. Better coordination among local practitioners, ambulance services and specialised hospitals can significantly reduce treatment time.

Dr Sricharan V, Associate Consultant-Neurology at SPARSH Hospital (Bengaluru) said advances in neuroimaging, critical care and minimally invasive neurological procedures have transformed treatment outcomes, but ensuring these technologies reach patients beyond major cities remains equally important.

Managing Blood Pressure May Protect The Brain

Experts emphasised that protecting brain health begins long before neurological symptoms appear.

Dr Sahil Kohli, Additional Director-Neurology at Fortis Hospital (Gurgaon) said uncontrolled hypertension damages the brain's small blood vessels over time, increasing the risk of stroke, cognitive decline and dementia.

Maintaining healthy blood pressure through regular exercise, a balanced diet, reduced salt intake, weight management, avoiding tobacco and adhering to prescribed medications can help preserve memory and thinking abilities.

Echoing this, Dr Sanjay Kumar, Senior Director-Cardiology at Fortis Hospital Faridabad, described hypertension as a "silent killer" whose effects extend well beyond the heart. Keeping blood pressure under control during middle age, he said, is among the most effective ways to reduce the risk of memory loss, cognitive impairment and stroke later in life.

Dr Chopra also stressed the importance of preventive health checks for people with diabetes and hypertension. Regular monitoring of blood pressure, glucose, HbA1c, lipid profile and other cardiovascular markers, along with medication adherence, healthy eating, exercise, smoking cessation and limiting alcohol intake, can significantly lower stroke risk.

Dr Animesh Gupta, Consultant-Neurology at Apollo Spectra Hospital, Kanpur, said everyday habits including quality sleep, regular physical activity, healthy nutrition, continued learning and maintaining social connections—play a vital role in preserving brain health. Avoiding self-medication, preventing head injuries through helmets and seatbelts, and addressing neurological symptoms without stigma are equally important.

New Diagnostics And Therapies Improving Outcomes

Experts said advances in diagnostics and rehabilitation are transforming neurological care.

Dr Deepak Sanghavi, Senior Vice President Operations and Chief of Mumbai Reference Lab at Agilus Diagnostics, said blood-based biomarkers are emerging as a promising tool for identifying Alzheimer's-related changes even before significant memory loss develops. While not yet a standalone diagnostic test, they can help identify people who require detailed neurological evaluation and allow earlier intervention.

Dr Praveen Gupta, Chairman, Marengo Asia International Institute of Neuro and Spine, Gurugram, highlighted the growing use of repetitive Transcranial Magnetic Stimulation (rTMS), a non-invasive therapy that stimulates targeted brain circuits to improve recovery after stroke. Besides aiding motor and speech rehabilitation, rTMS is also being used in selected patients with Parkinson's disease, chronic neuropathic pain, treatment-resistant depression and obsessive-compulsive disorder. However, he emphasised that it complements rather than replaces conventional medical treatment and rehabilitation.

Experts agreed that while neurological disorders are becoming more common, many can be prevented, detected early or effectively managed. Greater awareness of warning signs, routine health screening, timely specialist referrals and equitable access to neurological care will be crucial to reducing India's growing burden of brain diseases.