"Brain Screen": A self-referral, screening program for strokes, falls and dementia risk factors

J Neurol. 2006 Mar;253(3):307-15. doi: 10.1007/s00415-005-0986-6. Epub 2005 Oct 10.

Abstract

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) 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 micromol/L in 20%, >1 mm 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.

Publication types

  • Comparative Study

MeSH terms

  • Accidental Falls / statistics & numerical data*
  • Adult
  • Aged
  • Aged, 80 and over
  • Cholesterol / metabolism
  • Dementia / diagnosis*
  • Dementia / metabolism
  • Dementia / physiopathology
  • Female
  • Homocysteine / metabolism
  • Humans
  • Male
  • Mass Screening / methods
  • Middle Aged
  • Neuropsychological Tests
  • Referral and Consultation / statistics & numerical data
  • Risk Factors*
  • Stroke / diagnosis*
  • Stroke / metabolism
  • Stroke / physiopathology

Substances

  • Homocysteine
  • Cholesterol