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Is stroke history reliably reported by elderly with cognitive impairment? A community-based study
Ya-Ping Jin1, Silvia Di Legge, Truls Østbye
1Department of Clinical Neurological Sciences, London Health Sciences Centre and University of Western Ontario, London, Ontario, Canada.
Neuroepidemiology
|July 29, 2010
Summary
Elderly individuals with cognitive impairment accurately report their stroke history. This suggests that cognitive status does not affect self-reported stroke validity in older adults.
Area of Science:
- Gerontology
- Neurology
- Epidemiology
Background:
- Self-reported stroke history in the elderly is often questioned due to high rates of cognitive impairment.
- Cognitive impairment may affect an older adult's ability to accurately recall and report past medical events like stroke.
Purpose of the Study:
- To assess the validity of self-reported stroke history against clinical diagnosis in elderly individuals.
- To determine if cognitive impairment influences the accuracy of stroke self-reporting in older populations.
Main Methods:
- Utilized data from the Canadian Study of Health and Aging, Phase 1.
- Screened community-dwelling elderly participants (aged 65+) for self-reported stroke.
- Compared self-reports to physician-diagnosed stroke (gold standard) to calculate positive predictive value (PPV), sensitivity, and specificity.
Main Results:
- The PPV of self-reported stroke was 81% overall, with similar rates across cognitive statuses (76% cognitively normal, 84% CIND, 82% demented).
- Physician-diagnosed stroke was reported by 38% of cognitively normal, 54% of CIND, and 55% of demented participants.
- Specificity of self-reporting was high, exceeding 97% across all cognitive categories.
Conclusions:
- Cognitive impairment in community-dwelling elderly individuals does not necessarily lead to inaccurate self-reported stroke history.
- Frequent healthcare interactions among cognitively impaired elderly may enhance their awareness of stroke symptoms.
- Stroke is a risk factor for dementia development, underscoring the importance of stroke prevention, particularly in those with cognitive impairment.
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