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

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 μmol/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.