As many as 18 percent of adults who have no history of stroke report having had at least one symptom of stroke, according to results of a large national study published in the October 9 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.
Using brain imaging to screen individuals without a history of stroke reveals that many have had an undiagnosed or silent stroke, according to background information in the article. One previous study found that 11 percent of individuals age 55 to 64, 22 percent of those ages 65 to 69 and 43 percent of those older than 85 years show evidence of stroke despite never having been diagnosed with the condition. Because awareness of stroke symptoms is low, it is possible that these individuals had symptoms but did not recognize them or that the symptoms did not reach the threshold necessary for a stroke diagnosis.
Virginia J. Howard, M.S.P.H., of the University of Alabama at Birmingham, and colleagues analyzed data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, a random sample of 18,462 adults older than 45 years (average age 65.8) who had not been diagnosed with stroke. To ensure including many individuals at risk for stroke, the researchers included 7,567 African Americans (41 percent of the total sample, a higher ratio than in the general population) and 6,534 (35.4 percent of the sample) residents of the so-called "stroke belt," which includes eight Southeastern states with increased rates of stroke. In telephone interviews, participants provided information about demographics, general quality of life and medical history, including whether a physician had ever told them they had a stroke and whether they had experienced the sudden onset of any of six stroke symptoms. Brief physical examinations were conducted three to four weeks later. A stroke risk score was calculated for each individual based on demographics, behaviors and other risk factors, wit
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