"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.


OBJECTIVE
To assess whether a screening program of self-referred adults provides new and valuable medical information on risk factors for falls, stroke and dementia.


METHODS
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%.


CONCLUSIONS
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.
Giladi
Nir
N
Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center, 6 Weizman Street, Tel-Aviv 64239, Israel. ngiladi@tasmc.health.gov.il
Mordechovich
Michael
M
Gruendlinger
Leor
L
Shabtai
Herzel
H
Merims
Doron
D
Naor
Simona
S
Baltadzhieva
Rositsa
R
Hausdorff
Jeffrey M
JM
Gur
Alexander Y
AY
Bornstein
Natan M
NM
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002784:Cholesterol / Q000378:metabolism; D003704:Dementia / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology; D005260:Female; D006710:Homocysteine / Q000378:metabolism; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D009483:Neuropsychological Tests; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology
D006710:Homocysteine; D002784:Cholesterol