scholarly journals Do Silent Brain Infarctions Predict the Development of Dementia After First Ischemic Stroke?

2013 ◽  
Vol 1 (1) ◽  
pp. 66-69
Author(s):  
Ivan Barbov ◽  
Slavica Arsova ◽  
Arben Taravari ◽  
Vera Petrova
Keyword(s):  
Survival Analysis ◽  
Ischemic Stroke ◽  
Cognitive Function ◽  
Mental State ◽  
Total Sample ◽  
Ct Scans ◽  
Sample Population ◽  
Brain Infarcts ◽  
Increased Risk ◽  
Acute Event

Background: Silent brain infarctions (SBI) are common findings in advanced age, but their relationship to dementia is still uncertain.Aim: The present study was designed to evaluate whether SBI predict the development of dementia after first clinical ischemic stroke.Methods: We blindly studied admission CT scans of 102 consecutive nondemented patients presenting with ischemic stroke that clinically was their first stroke episode. SBI were defined as CT evidence of infarcts not compatible with the acute event. The patients were subsequently followed for their mental state for 2 years. Survival analysis, wherein onset of dementia was the end point, was performed on the total sample population and conducted separately on those with and without SBI at admission.Results: Dementia developed in 33 patients (32.3%), including 17 of the 37 (45.9%) with SBI and 16 of the 65 (24.6%) without SBI. Thus, dementia was strong related to SBI.Conclusion: Elderly people with silent brain infarcts and stroke have an increased risk of dementia and a steeper decline in cognitive function than those without such lesions.

scholarly journals OVERVIEW OF COGNITIVE FUNCTION IN THE ELDERLY WITH VARIATIONS OF TOTAL REMAINING TEETH REVIEW FROM MINI-MENTAL STATE EXAMINATION

2021 ◽  
Vol 9 (11) ◽  
pp. 168-181
Author(s):  
Ifwandi ◽  
Dewi Saputri ◽  
Liana Rahmayani ◽  
Pocut Aya Sofya ◽  
Syahrial ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Mental State ◽  
Tooth Loss ◽  
Mini Mental State Examination ◽  
The Elderly ◽  
Research Subjects ◽  
Increased Risk ◽  
History Of ◽  
The Impact ◽  
State Examination

When a person reaches the elderly phase, the function of the body's organs decreases, which causes an increased risk of disease and death. Including dental infections such as caries and periodontal disease which are the main factors for tooth loss. Tooth loss does not only affect the impact of mastication but also affects a person's cognitive function. This condition occurs because when a person loses teeth, the function of the Periodontal Mechanoreceptors decreases, disrupting the function of the hippocampus which is important for memory in the brain. Loss of a large number of teeth tends to indicate low cognitive function, but several factors affect cognitive function, namely education level, Diabetes Mellitus, Hypertension, heart disease, depression, sleep disorders, head injury, physical activity, and a history of smoking. Mini-Mental State Examination (MMSE) is a tool to assess a person's cognitive function. This study aims to see the description of cognitive function in the elderly at the Geunaseh Sayang Nursing Home with variations in the number of tooth losses. This study was conducted with 43 research subjects with interviews and intra-oral examination methods. Based on the results of the study, it can be concluded that the elderly who only have fewer teeth show a higher decline in cognitive function compared to the elderly with more teeth in the oral cavity. This is following the theory which states that the more teeth you lose, the lower your cognitive function will be. 

scholarly journals High-Sensitivity Cardiac Troponin T and Cognitive Function in Patients With Ischemic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (5) ◽  
pp. 1604-1607 ◽  
Author(s):  
Leonie H.A. Broersen ◽  
Bob Siegerink ◽  
Pia S. Sperber ◽  
Regina von Rennenberg ◽  
Sophie K. Piper ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Telephone Interview ◽  
Troponin T ◽  
High Sensitivity ◽  
Cognitive Status ◽  
State Examination

Background and Purpose— Our study aim was to assess whether high-sensitivity cardiac troponin T (hs-cTnT), a specific biomarker for myocardial injury, is associated with cognitive function in patients after mild-to-moderate first-ever ischemic stroke. Methods— We used data from PROSCIS-B (Prospective Cohort With Incident Stroke Berlin). Cognitive function was assessed by Mini-Mental-State-Examination at baseline, and Telephone Interview for Cognitive Status–modified after 1 to 3 years of follow-up. Patients were categorized according to hs-cTnT quartiles. We performed generalized linear regression to calculate risk ratios of cognitive impairment (Mini-Mental-State-Examination <27; Telephone Interview for Cognitive Status–modified <32). Association of hs-cTnT with cognitive function over time was estimated using a linear mixed model. Results— We included 555 patients (mean age, 67 years, 62% male, median National Institutes of Health Stroke Scale 2 [interquartile range, 1–5], hs-cTnT above upper reference limit 40%, baseline cognitive impairment 28%). Baseline Mini-Mental-State-Examination score and rate of cognitive impairment were lower in patients in the highest versus lowest hs-cTnT quartile (median Mini-Mental-State-Examination 27 versus 29, and 15.3% versus 43.0%, adjusted risk ratio, 1.76 [95% CI, 1.07–2.90], respectively). If anything, cognition seemed to improve in all groups, yet Telephone Interview for Cognitive Status–modified scores were consistently lower in patients within the highest versus lowest hs-cTnT quartile (adjusted β, −1.33 [95% CI, −2.65 to −0.02]), without difference in the rate of change over time. Conclusions— In patients with mild-to-moderate first-ever ischemic stroke without dementia, higher hs-cTnT was associated with higher prevalence of cognitive impairment at baseline and lower Telephone Interview for Cognitive Status–modified during 3-year follow-up. Registration— URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01363856.

scholarly journals Naturalistic exploratory study of the associations of substance use on ADHD outcomes and function

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Benjamin MacDonald ◽  
Joseph Sadek
Keyword(s):  
Substance Use ◽  
Performance Test ◽  
Continuous Performance Test ◽  
Total Sample ◽  
Cognitive Testing ◽  
Cannabis Use ◽  
Fine Motor ◽  
Future Research ◽  
Sample Population ◽  
Increased Risk

Abstract Background Although Attention Deficit Hyperactivity Disorder (ADHD) is associated with an increased risk of substance use disorder (SUD), existing literature on how SUD interacts with ADHD outcomes is limited. This study investigates whether SUD among individuals with ADHD is associated with worse ADHD outcomes and prognosis, and the association between overall functioning and SUD. In addition, we seek to understand whether heavy cannabis use is a better predictor of poorer outcomes compared to SUD status alone. Method We conducted a retrospective analysis on 50 ADHD patient charts, which were allocated based on SUD status. Subgroup analysis was performed on the total sample population, with allocation based on heavy cannabis use. Mann-Whitney and Chi-Square tests were used for both the primary and subgroup analyses. Results SUD status highly correlated with more ADHD-related cognitive impairments and poorer functional outcomes at the time of diagnosis. ADHD patients with comorbid ADHD-SUD scored significantly lower (p = < 0.0001) on objective cognitive testing (Integrated Auditory and Visual Continuous Performance Test (IVA/CPT)) than ADHD patients without SUD. The correlation with poorer ADHD outcomes was more pronounced when groups were allocated based on heavy cannabis use status; in addition to significantly lower IVA/CPT scores (p = 0.0011), heavy cannabis use was associated with more severe fine motor hyperactivity and self-reported hyperactivity/impulsivity scores (p = 0.0088 and 0.0172, respectively). Conclusion Future research is needed to determine how substance abuse can be a barrier to improved ADHD outcomes, and the effect cannabis and other substances have on cognitive function and pharmacotherapy of ADHD.

scholarly journals Cognitive function assessed by Mini-mental state examination and risk of all-cause mortality: a community-based prospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yongkang Su ◽  
Jing Dong ◽  
Jin Sun ◽  
Yan Zhang ◽  
Shouyuan Ma ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Mental State ◽  
Mini Mental State Examination ◽  
Cox Regression ◽  
Community Dwelling ◽  
Cognitive Test ◽  
Loss To Follow Up ◽  
Increased Risk ◽  
All Cause Mortality ◽  
State Examination

Abstract Background The Mini-Mental State Examination (MMSE) is the most widely used instrument to test cognitive functioning. The present study prospectively investigated the association between MMSE scores, MMSE domains, and all-cause mortality. Methods A total of 2134 participants aged 60 years or over, selected from one urban community-dwelling population in China, were enrolled in the study. The cognitive test was performed by use of the MMSE at baseline, and covariates were recorded simultaneously. Cox regression models were used for examining the cognitive function, expressed by different MMSE transformations, and all-cause mortality. After followed up for a median of 10.8 years (ranging from 1.0 to 11.3 years), loss to follow-up was 13.1% and 1854 individuals were finally included in the analyses. Results The subjects had the mean (SD) age of 71.01 (7.00) years, and 754 (40.67%) of them were women. Per point increase on MMSE scores was associated a 4% decreased risk of all-cause mortality [hazard ratio (HR): 0.96; 95%confidence interval (CI): 0.93–0.98]; compared to MMSE scores of ≥24, MMSE scores of < 24 was associated with a 43% increased risk of all-cause mortality (HR: 1.43; 95% CI: 1.05–1.95); compared to MMSE scores of 30, MMSE scores of 27–29 (HR: 1.27; 95% CI: 0.89–1.82), 24–26 (HR: 1.30; 95% CI: 0.86–1.99), and < 24 (HR: 1.79; 95% CI: 1.15–2.77) had a graded increase in risk of all-cause mortality (p for trend =0.003). Of MMSE domains, orientation to time (HR: 2.00; 95% CI: 1.29–3.11), attention and calculation (HR: 1.49; 95% CI: 1.16–1.92), recall (HR: 2.59; 95% CI: 1.22–5.47), and language (HR: 1.68; 95% CI: 1.25–2.26) were significantly associated with all-cause mortality in the unadjusted model; for one increase in the number of impaired MMSE domains, the unadjusted HR (95% CI) of mortality is 1.51 (1.38, 1.65), and the HR (95% CI) of mortality is 1.12 (1.01, 1.25) with full adjustment; compared to 0 and 1 impaired MMSE domains, the HRs of all-cause mortality associated with 2, 3, 4, and ≥ 5 impaired MMSE domains were 1.14 (95% CI: 0.84–1.54), 1.50 (95% CI: 0.98–2.28), 2.14 (95% CI: 1.12–4.09) and 2.29 (95% CI: 1.24–5.04), respectively, and a dose-dependent relationship was significant (p for trend =0.003). Conclusion Cognitive impairment is associated with the increased risk of all-cause mortality in the Chinese elderly. Similarly, reduced MMSE scores, as well as impaired MMSE domains, are also associated with the increasing risk of all-cause mortality.

scholarly journals PERBEDAAN GANGGUAN KOGNITIF SUBJEK STROKE ISKEMIK BERDASARKAN SISI HEMIPARESIS

2020 ◽  
Vol 37 (2) ◽  
Author(s):  
Gabriella Gabriella ◽  
Budi Riyanto Wreksoatmodjo ◽  
Andre Andre
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Mental State ◽  
Significant Relationship ◽  
Mini Mental State Examination ◽  
P Value ◽  
Stroke Patients ◽  
Cross Sectional ◽  
State Examination

DIFFERENCE OF COGNITIVE IMPAIRMENT IN ISCHEMIC STROKE PATIENTS BASED ON HEMIPARESIS SIDEABSTRACTIntroduction: Cognitive impairment in stroke has a significant impact on the quality of life and is different from the location of the lesion. Patients with a lesion in the left cerebral hemisphere tend to have cognitive impairment and dementia.Aim: This study investigates the relationship between the location of the lesion, which is manifested by hemiparesis side, and the occurrence of cognitive impairment in ischemic stroke patients.Method: A cross-sectional study was conducted in the population of ischemic stroke patients at Atma Jaya Hospital, who were registered from January 2014 to December 2018. Cognitive function was measured by the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment Indonesian Version (MoCA-Ina). Data were analyzed univariate and bivariate with the software program, statistical package for the social sciences (SPSS) version 25.0.Result: There were 125 patients included in this study, which predominantly was 55 years old and older (62.4%) and had a low education level (58.4%). The proportion of patients with right-sided hemiparesis (54.4%) was slightly higher than the left-side one (45.6%). No significant relationship was observed between the hemiparesis side and every cognitive function domain measured by MMSE and MoCA-Ina (p-value >0.05).Discussion Hemiparesis side indicating hemisphere lateralization in ischemic stroke patients showed no significant relationship with the occurrence of cognitive impairment based on MMSE and MoCA-Ina score.   Keywords: Cognitive impairment, hemisphere lateralization, ischemic stroke, MMSE score, MoCA-Ina scoreABSTRAKPendahuluan: Gangguan kognitif pada stroke menyebabkan penurunan kualitas hidup dan berbeda berdasarkan letak lesi. Berdasarkan letak lesi, lesi di hemisfer serebri kiri lebih sering menyebabkan gangguan kognitif dan demensia.Tujuan: Tujuan penelitian untuk mengetahui pengaruh perbedaan letak lesi dilihat dari sisi hemiparesis terhadap gangguan kognitif pada subjek stroke iskemik.Metode: Studi potong lintang dilakukan pada pasien stroke iskemik di RS Atma Jaya periode tahun 2014- 2018. Fungsi kognitif dinilai dengan menggunakan Mini Mental State Examination(MMSE) danMontreal Cognitive Assesment Indonesian Version(MoCA-Ina). Analisis data dilakukan secara univariat dan bivariat menggunakan menggunakan program sStatistical pPackage for the sSocial sSciences (SPSS) versi 25.0.Hasil: Sebanyak 125 pasien tergabung dalam penelitian ini, yang sebagian besar berusia ≥55 tahun (62,4%) dan memiliki tingkat pendidikan <9 tahun (58,4%). Proporsi pasien dengan hemiparesis kanan (54,4%) lebih besar daripada kiri (45,6%). Tidak terdapat hubungan antara sisi hemiparesis dengan skor MMSE dan MoCA-Ina pada semua ranah (nilai p >0,05).Diskusi: Sisi hemiparesis pasien stroke iskemik yang menunjukkan lateralisasi hemisfer serebri tidak berhubungan dengan gangguan kognitif berdasarkan skor MMSE dan MoCA-Ina.Kata kunci: Gangguan kognitif, lateralisasi hemisfer, skor MMSE, skor MoCA-Ina, stroke iskemik

scholarly journals Obesity as a Risk Factor for Failure to Wean from ECMO: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Syed Arsalan A. Zaidi ◽  
Kainat Saleem
Keyword(s):  
Risk Ratio ◽  
Meta Analysis ◽  
Survival Rates ◽  
Final Analysis ◽  
Total Sample ◽  
Sample Population ◽  
Obese Patients ◽  
Increased Risk ◽  
Significant Difference ◽  
Nonobese Patients

Purpose. Obesity has been associated with an increased risk of respiratory complications and other systemic illnesses. Respiratory dynamics in an obese patient, combined with modified lung physiology of ARDS, present a significant challenge in managing obese patients with ARDS. Many physicians think of obesity as a relative contraindication to ECMO. We performed a meta-analysis to see the effect of obesity on weaning from ECMO and survival to hospital discharge. Methods. We searched online databases for studies on ECMO and obesity. The search yielded 49 citations in total; after extensive review, six studies were assessed and qualified to be included in the final analysis. Patients were stratified into BMI >30 kg/m2 (obese) and BMI < 30 kg/m2 (nonobese). Results. In meta-analysis, there was a total sample population of 1285 patients, with 466 in the obese group and 819 in the nonobese group. There was no significant difference in weaning from ECMO when compared between obese and nonobese patients, with a risk ratio of 1.03 and 95% confidence interval (CI) of 0.94–1.13 (heterogeneity: chi2 = 7.44, df = 4 ( p = 0.11 ), I2 = 46%). There was no significant difference in survival rates between obese and nonobese patients who were treated with ECMO during hospitalization, with a risk ratio of 1.04 and 95% CI of 0.86–1.25 (heterogeneity: Tau2 0.03, chi2 = 14.61, df = 5 ( p = 0.01 ), I2 = 66%). Conclusion. Our findings show no significant difference in survival and weaning from ECMO in obese vs. nonobese patients. ECMO therapy should not be withheld from obese patients, as obesity is not a contraindication to ECMO.

scholarly journals Naturalistic Exploratory Study of the Associations of Substance Use on ADHD Outcomes and Function

2021 ◽  
Author(s):  
Benjamin MacDonald ◽  
Joseph Sadek
Keyword(s):  
Substance Use ◽  
Performance Test ◽  
Continuous Performance Test ◽  
Total Sample ◽  
Cognitive Testing ◽  
Cannabis Use ◽  
Fine Motor ◽  
Future Research ◽  
Sample Population ◽  
Increased Risk

Abstract Background: Although Attention Deficit Hyperactivity Disorder (ADHD) is associated with an increased risk of substance use disorder (SUD), existing literature on how SUD interacts with ADHD outcomes is limited. This study investigates whether SUD among individuals with ADHD is associated with worse ADHD outcomes and prognosis, and the association between overall functioning and SUD. In addition, we seek to understand whether heavy cannabis use is a better predictor of poorer outcomes compared to SUD status alone. Method: We conducted a retrospective analysis on 50 ADHD patient charts, which were allocated based on SUD status. Subgroup analysis was performed on the total sample population, with allocation based on heavy cannabis use.Mann-Whitney and Chi-Square tests were used for both the primary and subgroup analyses. Results: SUD status highly correlated with more ADHD-related cognitive impairments and poorer functional outcomes at the time of diagnosis. ADHD patients with comorbid ADHD-SUD scored significantly lower (p=<0.0001) on objective cognitive testing (the continuous performance test). The correlation with poorer ADHD outcomes was more pronounced when groups were allocated based on heavy cannabis use status, where in addition to significantly lower objective cognitive testing scores (p=0.0011), heavy cannabis use was associated with more severe fine motor hyperactivity and self-reported hyperactivity/impulsivity scores (p=0.0088 and 0.0172, respectively). Conclusion: Future research is needed to determine how substance abuse can be a barrier to improved ADHD outcomes, and the effect cannabis and other substances have on cognitive function and pharmacotherapy of ADHD.

Prognostic significance of serum neurofilament light chain in acute ischemic stroke: a retrospective cohort study (Preprint)

2020 ◽  
Author(s):  
Zhongchen Mao ◽  
Zhixin Fu ◽  
Jinhua Zhang ◽  
Yan Zhao ◽  
Yong Sun ◽  
...  
Keyword(s):  
Cohort Study ◽  
Ischemic Stroke ◽  
Cognitive Function ◽  
Acute Ischemic Stroke ◽  
Daily Activity ◽  
Prognostic Significance ◽  
Neurofilament Light ◽  
Baseline Serum ◽  
Increased Risk

BACKGROUND Acute ischemic stroke affects a large number of people each year around the world. However, accurately predicting clinical outcome is still difficult. OBJECTIVE The aim of this cohort study was to explore the relationship between serum neurofilament light (NfL) concentration and clinical outcomes in these patients. METHODS A total of 820 patients with acute ischemic stroke were retrospectively enrolled between January 2012 and June 2017. Changes in patients' conditions, imaging data and other necessary information were obtained from their medical records. Blood samples were collected several times during the first two weeks of admission. Serum NfL levels were measured using a commercial Simoa NfL assay. In 6-month follow-up period, daily activity and cognitive function were assessed using modified Rankin Scale and Mini-mental State Examination. RESULTS Serum NfL levels gradually increased after the disease onset and peaked on the 7th day of admission. The elevated levels of peak NfL were roughly associated with the increased risk of poor daily activity function (OR: 2.92, 95%CI: 1.66 - 5.13), poor cognitive function (OR: 1.54, 95%CI: 1.03 - 2.29; OR: 1.66, 95%CI: 1.11 - 2.47; OR: 1.55, 95%CI: 1.03 - 2.37) and greater cognitive decline during the follow-up period (OR: 2.38, 95%CI: 1.07 - 5.26; OR: 1.99, 95%CI: 1.01 - 3.97). However, baseline serum NfL levels did not have similar prognostic significance. CONCLUSIONS Elevated peak concentration of NfL in serum predicts poor daily activity performance and cognitive function decline, and might be a prognostic biomarker for acute ischemic stroke. CLINICALTRIAL None.

Abstract 12946: Higher Burden of Atrial Fibrillation is Independently Associated With Lower Cognitive Function: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Lin Y Chen ◽  
Sunil K Agarwal ◽  
Faye L Lopez ◽  
Rebecca F Gottesman ◽  
Laura R Loehr ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Cognitive Function ◽  
Heart Rhythm ◽  
Cognitive Test ◽  
Cognitive Tests ◽  
Recording Device ◽  
Cross Sectional ◽  
Increased Risk ◽  
Aric Study

Background: Atrial fibrillation (AF) is associated with greater cognitive decline and increased risk of dementia. However, it is unknown whether AF burden (% of time a person is in AF) is associated with cognition. We aimed to assess the cross-sectional association of AF burden with cognitive test scores in the ARIC study, a community-based prospective cohort study in the USA. Methods: We included 325 (mean age, 76.9 ± 5.2 years; 52.9% female) participants who underwent cognitive tests (Table) and ≥2 days of heart rhythm recording using the Zio ® Patch (a non-invasive, leadless, 2-week continuous ECG recording device by iRhythm Techonologies, Inc.) in July 2013-March 2014. We used multivariable linear regression to assess the association of AF burden (dichotomized at the median) with standardized z-scores of cognitive tests. Results: The mean wear and analysis time of the Zio ® Patch were 13.1 ± 2.1 and 12.7 ± 2.3 days, respectively. Of 325 participants, 13 (4.0%) had a prior ischemic stroke. There were 26 (8%) participants with AF recorded (median AF burden among participants with AF, 51%), of whom 4 (15.4%) had a prior ischemic stroke. Compared with absence of AF, higher AF burden was independently associated with lower MMSE, DWR, and AN scores, but not DSS and CTP. Conclusions: Higher burden of AF is independently associated with lower cognitive function, specifically memory and verbal function. This association needs to be confirmed prospectively and further research is needed to elucidate its mechanism.

Abstract P57: Risk Factors for Incidentally Discovered Silent Brain Infarcts and White Matter Disease in a Real World Cohort Identified by Artificial Intelligence

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Lester Y Leung ◽  
Yichen Zhou ◽  
Sunyang Fu ◽  
Chengyi Zheng ◽  
Hongfang Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
White Matter ◽  
Language Processing ◽  
Real World ◽  
Stroke Risk ◽  
Advanced Age ◽  
White Matter Disease ◽  
Brain Infarcts ◽  
Increased Risk

Introduction: Silent brain infarcts (SBIs) and white matter disease (WMD) are highly prevalent and associated with increased risk of ischemic stroke in patients with traditional stroke risk factors (RFs) in prospective cohort studies. Their frequency and associations with stroke RFs have not been well described in real world populations. Methods: This was a cross-sectional study of patients age ≥ 50 in the Kaiser Permanente-Southern California (KPSC) health system between 2009-2019 with a head CT or MRI for non-stroke indications and no history of ischemic stroke, transient ischemic attack, or dementia. A natural language processing (NLP) algorithm developed at Mayo Clinic and Tufts Medical Center was applied to the KPSC EHR to identify individuals with reported SBIs or WMD. Multivariable Poisson regression with robust error variance was used to estimate risk ratios of demographics, stroke RFs (from the Framingham Stroke Risk Score), and scan modality on the presence of SBIs or WMD. Results: Among 262,875 individuals, the NLP identified 13,154 (5.0%) with SBIs and 78,330 (29.8%) with WMD. Stroke RFs were highly prevalent in this cohort. The majority underwent CTs (74.8%) instead of MRIs as their initial neuroimaging. After adjustment for demographics and RFs, advanced age demonstrated a strong association with increased risk of SBIs and WMD (table). MRI was associated with a reduced risk of reported SBIs (ARR: 0.87, 95% CI 0.83-0.91) and an increased risk of reported WMD (ARR 2.86, 95% CI 2.83-2.90). Despite being prevalent, traditional stroke RFs had weak associations with increased risk of SBIs or increased risk of WMD. Conclusions: Advanced age is strongly associated with incidentally discovered SBIs and WMD on neuroimaging studies obtained in routine care. The development of SBIs and WMD may not be fully attributable to traditional stroke RFs.

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