A DEMOGRAPHIC FACTORS ASSOCIATED WITH PUBLIC KNOWLEDGE OF STROKE SYMPTOMS AMONG ASIAN POPULATIONS: A NARRATIVE REVIEW
DOI:
https://doi.org/10.31603/d5hz6d23Keywords:
Asian population, Demographic factors, Early detection, Stroke knowledgeAbstract
Public knowledge of stroke symptoms plays an important role in early recognition and timely treatment, particularly in the pre-hospital phase. In Asian populations, demographic characteristics may influence the level of awareness, but findings across studies have not always been consistent. This article aimed to review the relationship between demographic factors and knowledge of stroke symptoms through a narrative review of previous studies. Ten cross-sectional studies published between 2020 and 2025 were identified through database searches in PubMed and Google Scholar with predefined inclusion criteria. The included studies involved heterogeneous populations, including community-based samples, older adults, healthcare professionals, and outpatients with recurrent stroke or transient ischemic attack. Overall, the findings showed that education was the most consistent factor associated with better stroke knowledge. In contrast, associations with age, information sources, place of residence and socioeconomic status varied across studies and settings. Recognition of core stroke symptoms, particularly those reflected in the FAST concept, tended to be better than knowledge of less consistently identified symptoms and appropriate response patterns. Several studies also showed persistent gaps in prevention knowledge, symptom recognition and emergency response. These findings suggest that stroke awareness in Asian populations remains heterogeneous. Community-based education and improved access to context-appropriate health information are therefore needed to strengthen public understanding of stroke symptoms and support early recognition and response.
References
Abbasian, M., Rashidi Birgani, H., Khabiri, R., Namvar, L., & Jahangiry, L. (2024). Exploring Education Interventions for Stroke Prevention Among Adults and Older Individuals: A Scoping Review. In Health Science Reports (Vol. 7, Number 11). John Wiley and Sons Inc. https://doi.org/10.1002/hsr2.70167
Barakat, M., A. AlSalamat, H., Jirjees, F., Al-Obaidi, H., k. Hussain, Z., El Hadidi, S., Mansour, S., Malaeb, D., & Hosseini, H. (2021). Factors Associated with Knowledge and Awareness of Stroke Among the Jordanian Population: A Cross-Sectional Study. F1000Research, 10, 1242. https://doi.org/10.12688/f1000research.74492.1
Chang, T., Ibrahim, S., Ranasinghe, H. M., Mihirini, A. H. T. M., Weerasinghe, D., Vithanage, T. D. P., Banagala, C., & Arambepola, C. (2020). Knowledge of Stroke, Its Warning Symptoms, Risk Factors and Treatment among the General Public and General Practitioners in a South Asian Population. Journal of Stroke and Cerebrovascular Diseases, 29(5). https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104760
Feigin, V. L., Abate, M. D., Abate, Y. H., ElHafeez, S. A., Abd-Allah, F., Abdelalim, A., Abdelkader, A., Abdelmasseh, M., Abd-Elsalam, S., Abdi, P., Abdollahi, A., Abdoun, M., Abd-Rabu, R., Abdulah, D. M., Abdullahi, A., Abebe, M., Zuñiga, R. A. A., Abhilash, E. S., Abiodun, O. O., … Murray, C. J. L. (2024). Global, regional, and national burden of stroke and its risk factors, 1990–2021: A systematic analysis for the global burden of disease study 2021. The Lancet Neurology, 23(10), 973–1003. https://doi.org/10.1016/S1474-4422(24)00369-7
Heuschmann, P. U., Zweynert, S., Sobesky, J., Nolte, C. H., Audebert, H. J., Hantke, C., Koennecke, H. C., Kalic, M., Berger, K., & Endres, M. (2021). Effects of a Public Awareness Campaign on Time to and Way of Hospital Admission After Stroke. SAGE Open, 11(1), 1–9. https://doi.org/10.1177/2158244021989275
Kharaba, Z., Alfoteih, Y., Jirjees, F., Albarbandi, M., Hussain, Z., Al Obaidi, H., Mansour, S., Ahmed, M., Eltayib, E., Barakat, M., AlSalamat, H. A., Alzayer, R., El Khatib, S., Al-Mohammad, S., Hallit, S., Malaeb, D., & Hosseini, H. (2024). Assessment of knowledge and awareness of stroke among the Syrian population: unveiling the current landscape in Syria through the first nationally representative study. Scientific Reports, 14(1), 1–14. https://doi.org/10.1038/s41598-024-64935-3
Kleinig, T. J., McMullan, P., Cloud, G. C., Bladin, P. C., & Ranta, A. (2024). Hyper-acute stroke systems of care and workflow. Current Neurology and Neuroscience Reports, 24(10), 495–505. https://doi.org/10.1007/s11910-024-01367-6
Lobo, E. H., Gill, P., Woloszczuk, C., Woods, L., Wang, K., Pole, J. D., Frølich, A., Horton, E., & Turner, A. (2025). Knowledge, Attitudes and Practice of Informal Caregivers of People Living With Stroke: A Scoping Review of Recent Literature. In Journal of Advanced Nursing. John Wiley and Sons Inc. https://doi.org/10.1111/jan.16942
Mubaraki, A. A., Alqahtani, A. S., Almalki, A. A., Almalki, A. H., Alamri, H. M., Aburass, M. K., & Althumali, Z. H. (2021). Public knowledge and awareness of stroke among adult population in Taif city, Saudi Arabia. Neurosciences, 26(4), 339–345. https://doi.org/10.17712/nsj.2021.4.20210057
Ramadan, A., Kharaba, Z., Ghemrawi, R., Elnour, A. A., Hussain, N., Kouhgard, P., Al-Damook, N., Abou Hait, S., Al Ghanem, L., Atassi, R., Chkh Sobeh, R., & Z. Al Meslamani, A. (2023). Are we aware of stroke risk factors and warning signs amid COVID-19? Knowledge and attitude towards risk-factors, signs and symptoms of stroke among the UAE population during COVID-19 pandemic: A cross-sectional study. F1000Research, 12, 322. https://doi.org/10.12688/f1000research.129873.1
Rioux, B., Brissette, V., Marin, F. F., Lindsay, P., Keezer, M. R., & Poppe, A. Y. (2022). The impact of stroke public awareness campaigns differs between sociodemographic groups. Canadian Journal of Neurological Sciences, 49(2), 231–238. https://doi.org/10.1017/cjn.2021.76
Saade, S., Hallit, S., Salameh, P., & Hosseini, H. (2022). Knowledge and Response to Stroke Among Lebanese Adults: A Population-Based Survey. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.891073
Sakr, F., Safwan, J., Cherfane, M., Salameh, P., Sacre, H., Haddad, C., El Khatib, S., Rahal, M., Dia, M., Harb, A., Hosseini, H., & Iskandar, K. (2023). Knowledge and Awareness of Stroke among the Elderly Population: Analysis of Data from a Sample of Older Adults in a Developing Country. Medicina (Lithuania), 59(12). https://doi.org/10.3390/medicina59122172
Wanichanon, W., Ananchaisarp, T., Buathong, N., & Choomalee, K. (2024). Knowledge and attitude towards stroke among the population of one rural community in southern Thailand: a survey. BMJ Open, 14(2), 1–10. https://doi.org/10.1136/bmjopen-2023-080269
Widjaja, K. K., Chulavatnatol, S., Suansanae, T., Wibowo, Y. I., Sani, A. F., Islamiyah, W. R., & Nathisuwan, S. (2021). Knowledge of stroke and medication adherence among patients with recurrent stroke or transient ischemic attack in Indonesia: A multi-center, cross-sectional study. International Journal of Clinical Pharmacy, 43(3), 666–672. https://doi.org/10.1007/s11096-020-01178-y
World Health Organization. (2024). World health statistic 2024. https://iris.who.int/bitstream/handle/10665/376869/9789240094703-eng.pdf?sequence=1
Zhang, X., Liu, Y., Cao, X., Xu, X., Zhu, Y., & Wang, C. (2020). Effect of multi-level stroke education on treatment and prognosis of acute ischemic stroke. Experimental and Therapeutic Medicine, 2888–2894. https://doi.org/10.3892/etm.2020.9028
Zhao, Y., Xu, Y., Fang, S., Zhi, S., Ma, D., Song, D. P., Gao, S., Wu, Y., Zhong, Q., Jin, C., Wang, R., & Sun, J. (2024). Incidence and Associated Factors of Prehospital Care-Seeking Delay in People with Acute Ischemic Stroke: A Systematic Review and Meta-Analysis. Neuroepidemiology, 1–16. https://doi.org/10.1159/000542765
Zhong, X., Wang, J., He, L., & Xu, R. (2020). Recognition of stroke-related knowledge among community residents and the improvement after intensive health education: A cross-sectional study. BMC Neurology, 20(1), 1–7. https://doi.org/10.1186/s12883-020-01951-6
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