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

Reducing Risk of Stroke and DementIa In patientS With COVert cERebrovascular Disease: a Pilot and Development Study

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