title: Stroke Awareness Is Worse among the Old and Poorly Educated: A Population-Based Survey.
abstract: BACKGROUND
  This article surveys a representative sample of adults to assess their knowledge of stroke, its vascular risk factors and warning symptoms, illness perception, and attitude toward strokes.
  
  
  METHODS
  A representative sample of the region population was selected using a double randomization design. Previously trained medical students carried out face-to-face interviews using a structured questionnaire with open- and closed-ended questions.
  
  
  RESULTS
  In all, 2411 subjects were interviewed. Seventy-three percent reported at least 1 correct warning sign of stroke, whereas only 12.2% reported 3. The most frequently mentioned were sudden weakness, dizziness, and headache. Only 59.2% named at least 1 correct risk factor for stroke. Smoking and hypertension were mainly named. Forty percent of the respondents demonstrated adequate knowledge of stroke. Tellingly, prevalence of adequate knowledge was significantly lower in subjects with previous stroke (29.3% [95% confidence interval {CI}, 19.7-40.3], P = .049), hypertension (35.0% [95% CI, 31.1-39.1], P = .009), diabetes (31.9% [95% CI, 25.9-38.3], P = .011), hypercholesterolemia (35.8% [95% CI, 31.8-39.9], P = .03), and obesity (28.2% [95% CI, 23.8-33.0], P < .001). Illness perception was generally correct. In the final logistic regression model, younger age, urban area of residence, higher educational level, higher family income, normal pressure, normal weight, and family history of stroke were associated with adequate knowledge of stroke.
  
  
  CONCLUSIONS
  Basic knowledge of stroke is insufficient among the general population of Extremadura. There is a discrepancy between theoretical stroke knowledge and illness perception. These findings have implications for public health initiatives for stroke.
authors: Department of Neurology, Hospital Infanta Cristina, Badajoz, Spain; Department of Biomedical Sciences, Faculty of Medicine, University of Extremadura, Badajoz, Spain. Electronic address: j.ramrez@gmail.com.
authors: José María
authors: JM
authors: Ramírez-Moreno
authors: Adult Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton Hospital, London, United Kingdom.
authors: Rafael
authors: R
authors: Alonso-González
authors: Department of History and Bioethics, University of Extremadura, Badajoz, Spain.
authors: Diego
authors: D
authors: Peral-Pacheco
authors: Department of Cardiology, Hospital Universitario Cristina, Badajoz, Spain.
authors: María Victoria
authors: MV
authors: Millán-Núñez
authors: Department of Neurology, Hospital Infanta Cristina, Badajoz, Spain; Department of Cardiology, Hospital Universitario Cristina, Badajoz, Spain.
authors: José Javier
authors: JJ
authors: Aguirre-Sánchez
mesh_terms: D000368:Aged; D000375:Aging / Q000523:psychology*; D001364:Awareness; D018672:Community Health Planning; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011634:Public Health; D012307:Risk Factors; D013030:Spain; D020521:Stroke / Q000453:epidemiology* / Q000523:psychology*
keywords: Stroke; health promotion; knowledge; population survey; risk factors; warning signs