Functional and cognitive consequences of silent stroke discovered using brain magnetic resonance imaging in an elderly population.

OBJECTIVES

To evaluate the prevalence of silent stroke and its associated consequences on physical, cognitive, and emotional functioning in an elderly population.

DESIGN

Population-based cross-sectional survey.

SETTING

The Memory and Morbidity in Augsburg Elderly project in the Augsburg region of southern Germany.

PARTICIPANTS

Two hundred sixty-seven community-dwelling persons aged 65 to 83.

MEASUREMENTS: The presence of silent stroke was determined using magnetic resonance imaging brain scan and a single question asking for physician-diagnosed stroke in each participant. The health effect of silent stroke was assessed using rating scales for self-perceived health status (36-item short-form health survey), activities of daily living (ADLs) and instrumental ADLs, cognitive function, and depression (Center for Epidemiologic Studies Depression scale).

RESULTS

Just fewer than 13% (12.7%) of participants were affected by silent stroke. Silent stroke was associated with a history of hypertension, heart surgery, and elevated C-reactive protein. Individuals with silent stroke showed impairments on the Mini-Mental State Examination test and in the cognitive domains of memory, procedural speed, and motor performance.

CONCLUSION

The presence of silent stroke has a considerable effect on cognitive performance in those affected. Determining the presence of silent stroke using brain imaging may contribute to identifying individuals at risk for developing gradual neurological deficits.