Periodontal disease is a potential predictor of stroke and cognitive impairment. However, this association is unclear in adults aged 50 yr and above without a history of stroke or dementia. We evaluated the association between the number of teeth lost, indicating periodontal disease, and cognitive impairment in community-dwelling adults without any history of dementia or stroke. Dental examinations were performed on 438 adults older than 50 yr (315 females, mean age 63 ± 7.8 yr; 123 males, mean age 61.5 ± 8.5 yr) between January 2009 and December 2010. In the unadjusted analysis, odds ratios (OR) of cognitive impairment based on MMSE score were 2.46 (95% CI, 1.38-4.39) and 2.7 (95% CI, 1.57-4.64) for subjects who had lost 6-10 teeth and those who had lost more than 10 teeth, respectively, when compared with subjects who had lost 0-5 teeth. After adjusting for age, education level, hypertension, diabetes, hyperlipidemia, and smoking, the relationship remained significant (OR, 2.0; 95% CI, 1.08-3.69, P = 0.027 for those with 6-10 teeth lost; OR, 2.26; 95% CI, 1.27-4.02, P = 0.006 for those with more than 10 teeth lost). The number of teeth lost is correlated with cognitive impairment among community-dwelling adults aged 50 and above without any medical history of stroke or dementia.

Objectives: This study evaluated the effects and relevant factors of community-based education and advocacy intervention on stroke awareness among the general population. Methods: The study enrolled 505 community-dwelling adults aged 19 years or older who completed a survey before and after a community-based intervention held between May 2014 and December 2014. Trained staff collected data about knowledge of five stroke warning signs, emergency response, golden window of time (≤3 h), and demographics. Results: After the intervention, public awareness of all five stroke warning signs increased significantly from 26.5% to 33.9% (p=0.011). Public awareness of the golden window of time also increased significantly from 70.1% in April 2014 to 75.8% in December 2014 (p=0.040). In a multivariate logistic regression analysis, older age, higher education level, and exposure to stroke-related public service announcements or educational materials were significant predictors of knowledge of all five warning signs for stroke. Conclusions: Comprehensive community-based intervention is effective for improving public awareness of the warning signs of stroke and the golden window of time.

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Background: We assessed the effects of customized in-hospital, in-person education provided by an education-specialized nurse in ischemic stroke patients. Methods: All ischemic stroke patients who were hospitalized between April 2015 and December 2015 were included. They were provided with education about stroke by an education-specialized nurse during their hospital stay. The knowledge of stroke warning signs and appropriate responses was examined both before the in-hospital education and 3 months after discharge in 127 patients. Results: The awareness of the following stroke warning signs increased significantly at 3 months after discharge compared to before receiving the education (all p values <0.001): sudden difficulty in speaking or in understanding speech (74.0→93.7%), sudden numbness or weakness (72.4→92.1%), sudden dizziness (71.7→89.8%), sudden severe headache (44.9→82.7%), and sudden visual impairment (38.6→69.3%). The proportion of patients with a good knowledge of stroke warning signs (defined as providing at least five correct answers) increased significantly, from 38.6% to 81.9%. Almost half of them (46.5%) correctly answered that they should call an ambulance first when someone shows stroke symptoms before receiving the education, with this proportion increasing to 68.5% at 3 months after discharge (p<0.001). The proportions of patients who understood the need for prompt treatment of stroke and the golden time window increased from 80.3% to 96.9% and from 66.1% to 86.6%, respectively (both p<0.001). The proportion of patients with knowledge of thrombolytic therapy for stroke also increased significantly after the in-hospital education, from 11.0% to 76.4% (p<0.001). Conclusions: In-hospital, in-person education was effective at increasing the understanding that patients have of stroke, even at 3 months after discharge. In-hospital education provided by an education-specialized nurse would be an effective intervention for increasing the likelihood of stroke patients reacting appropriately to stroke recurrence.