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.

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

People aged 65 years or older living in Scotland, UK

Published results will not contain any personal data that could allow identification of individual participants.