Reducing Risk of Stroke and DementIa In patientS With COVert cERebrovascular Disease

N/ANot Yet RecruitingNCT06878430

University of Edinburgh100 enrolled

Overview

The purpose of the DISCOVER study is to pilot acceptable approaches to people with covert cerebrovascular disease (CCD) and their follow-up. This is the first step in designing efficient randomised trials of treatments to reduce the risk of stroke or dementia in people with CCD.

DISCOVER is a prospective cohort involving individuals with covert cerebrovascular disease (CCD) in NHS Lothian. Participants will be recruited through electronic health records and clinician collaborators. Participants will be monitored at 3 and 6 months and where possible 12 months to assess cognitive, functional, and vascular event outcomes.

Study Type

OBSERVATIONAL

Enrollment

100

Conditions

Covert Cerebrovascular Disease

Interventions

Functional and Cognitive scoresOTHER

We will collect information about prior neurological symptoms, including prior symptoms suggestive of TIA or stroke, cognitive or motor symptoms, blood pressure and other known vascular risk factors, medicines, frailty, functional status, education, and employment status We will collect a baseline validated function and cognitive score, and take a sample of speech. Speech will be measured at assessment, in collaboration with the NeuroCARE Clinical and Digital Measures Module (22/SS/0010 IRAS No. 310885).

Eligibility

Sex: ALLMin age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * People who, at the time the letter is prepared or are identified by a clinician * Age ≥ 65 years * Have no known history of: * Stroke or TIA * Dementia * Parkinson's disease * Multiple sclerosis * Metastatic cancer (or non-meningioma brain tumour). * A CT or MRI scan report ≤5 years before study start date with of one or more of: * Cerebral small vessel disease * Deep old ischaemic stroke * Cortical old ischaemic stroke Exclusion Criteria: * Text of brain scan report unreadable * Do not consent to take part in study procedures * Unable to consent * Unable to communicate by email, letter or telephone through language, speech disability or lack of address * Unlikely to survive one year past enrolment in judgement of the study investigator

Outcomes

Primary Outcomes

Functional scores

The investigators will measure day-to-day function with the Bristol Activities of Daily Living Scale, which is a 20-item assessment of daily living abilities for dementia. Each activity has 5 statement options (a - e) which refer to a different level of ability.

Time frame: At 3, 6 and 12 months following enrolment

Cognitive scores

The investigators will measure concerns or anxiety about covert cerebrovascular disease using the Montreal Cognitive Assessment. It is a 10-minute test that assesses seven areas of cognition for a total possible score of 30 points. A score of 25 or less is indicative of cognitive impairment.

Time frame: At 3, 6 and 12 months following enrolment

Speech samples

Speech will be measured at assessment, in collaboration with the NeuroCARE Clinical and Digital Measures Module (22/SS/0010 IRAS No. 310885).

Time frame: At 3, 6 and 12 months following enrolment

Vascular events

At each assessment the investigators will ask about dementia, mild cognitive impairment and stroke symptoms.

Time frame: At 3, 6 and 12 months following enrolment

Central Contacts

William Whiteley

CONTACT

+44(131) 4659602 william.whiteley@ed.ac.uk

Data from ClinicalTrials.gov

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