4.7 Article

Brain screen - A self-referral, screening program for strokes, falls and dementia risk factors

Journal

JOURNAL OF NEUROLOGY
Volume 253, Issue 3, Pages 307-315

Publisher

SPRINGER HEIDELBERG
DOI: 10.1007/s00415-005-0986-6

Keywords

risk factor; prevention; stroke; dementia; fall

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Background Falls, strokes and dementia can be predicted and their occurrence can be delayed or even prevented by treatment of risk factors. The value of screening self-referred adults is unknown. Objectives To assess whether a screening program of self-referred adults provides new and valuable medical information on risk factors for falls, stroke and dementia. Method We examined 514 self-referred people (59% women, mean age 68 +/- 8 years (range 44-89) and 14 +/- 3 years of education) in our '' Brain Screen '' program. Participants completed detailed questionnaires and underwent a neurological examination, computerized gait analysis, carotid Duplex, serum lipid and homocysteine levels, a computerized neuropsychological battery (NeuroTrax (R)) and the Mini-Mental State Exam. Information that was detected by '' Brain Screen '' was compared with the self-reported data. Results Unknown vascular risk factors detected by '' Brain Screen '' included: high cholesterol in 44%, homocysteine > 10 mu mol/L in 20%, > 1mm carotid intima-media thickness in 13%, and carotid narrowing (> 30%) in 2.2%. Unknown risk factors for falls were detected in 66% of the subjects who never fell. Of the 205 subjects (44%) who complained of memory decline, 28% had objective memory disturbances compared with their age group. Mild cognitive impairment (amnestic MCI) was clinically diagnosed in 17% of the population and dementia in 5%. Conclusion Screening self-referred adults for falls, strokes and dementia risk factors detected significant unknown risk factors that can be treated in more than one-third of the participants. A national '' Brain Screen '' program can have significant impact on the health of the aging population.

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