Singh, Sanewal2025-09-172025-09-172025-09-172025-09-05https://hdl.handle.net/10012/22457While the incidence of stroke continues to decline among older adults in most parts of the world, stroke rates in younger adults have shown a concerning rise. Despite growing awareness and research, the etiology and risk profiles of stroke in young adults remains poorly understood and often explained using studies focused on older populations. However, applying findings from older adults to younger populations may be limited, due to given substantial differences in lifestyle and health risk factors. To better understand the rise of stroke in young adults, this thesis utilizes a case-control study design with primary data to investigate the sociodemographic, behavioural, and clinical characteristics of stroke in young adults. This thesis includes a four-paper approach. The first study provides a comprehensive descriptive analysis of young adult stroke survivors, with a comparison to healthy adults within the same age range. The purpose of this study is to identify the sociodemographic attributes (e.g., race, education level, income), lifestyle factors (e.g., exercise, diet), health conditions (e.g., hypertension, heart conditions), and unique risk factors to young adults (e.g., caffeine consumption, mental health). Additionally, this study examines the temporal patterns of comorbidities in relation to stroke occurrence. Thereby, this study distinguishes between pre-existing and post-stroke diagnoses, and thus provides temporal insight into identifying prevalent risk factors and those that may go undiagnosed. The second study uses a multiple conditional logistic regression analysis to explore the associations between a broad range of established and emerging risk factors and stroke risk in young adults. This paper expands on previous research by considering risk factors that may be unique to young adults, such as mental health conditions, substance use, and certain lifestyle factors. This paper challenges the direct application of risk factor analyses developed among older adults, underscoring the importance of age-specific research. The third study examines the relationship between caffeine intake and stroke risk in young adults. Specifically, this paper examines the overall association between daily caffeine consumption and stroke risk, as well as the dose-and source-specific impact (e.g., coffee, tea, energy drinks, soda). Notably, this study approaches the intake of caffeine and various sources as a non-linear association, which is often overlooked in the progression of cardiovascular disease. Given that caffeine is widely consumed in young adults, this study offers new perspectives into how it may influence cerebrovascular health amongst this population. Study four highlights the challenges of recruiting participants from rare or uncommon populations and presents a key methodological contribution of this thesis. Specifically, it examines the challenges of using traditional methods of recruitment, such as polling firms or clinical settings, which are often costly, time consuming, and limited in their reach. This paper demonstrates the use of social media as a cost-effective solution to the aforementioned recruitment challenges, using young adults who have experienced a stroke as an example. Nonetheless, study four highlights the key considerations for researchers planning on using social media for recruitment of rare or uncommon populations, while also acknowledging its limitations. Together, this thesis seeks to provide a novel, multifactorial analysis of stroke risk in young adults by incorporating both established and emerging variables, as well as focusing on age-specific risk factors. In addition, this thesis offers a key methodological contribution to the field of stroke research by demonstrating the effective use of social media for recruiting uncommon populations and by capturing temporal patterns of health conditions related to stroke onset. Overall, this thesis aims to advance the current understanding of stroke risk in young adults and highlights the need for prevention and clinical strategies specific to their unique risk profiles.enMEDICINE::Social medicine::Public health medicine research areas::EpidemiologyMEDICINE::Social medicine::Public health medicine research areas::Public health scienceSOCIAL SCIENCES::Statistics, computer and systems science::Statistics::BiostatisticsNATURAL SCIENCES::BiologyMEDICINE::Dermatology and venerology,clinical genetics, internal medicine::Internal medicine::Cardiovascular medicineMEDICINE::Dermatology and venerology,clinical genetics, internal medicine::Internal medicine::CardiologyMEDICINE::Social medicine::Public health medicine research areasDoctoral Thesis