NEW YORK (Reuters Health) – Symptoms consistent with stroke in the absence of an actual stroke diagnosis adversely affect physical functioning and quality of life, US researchers report.

"Many clinicians argue that there is no need to do an extensive work-up for vague (stroke) symptoms, but these vague symptoms substantially lower a person’s quality of life and cause cognitive impairment and possibly other harmful effects that potentially indicate a silent stroke," lead author Dr. George Howard, from the University of Alabama at Birmingham, said in a statement.

The findings, which appear in the August 2nd online issue of Stroke, stem from a comparison of mental and physical functioning in 16,090 symptom-free subjects, 3404 subjects with stroke symptoms but no formal diagnosis, 1491 patients with a prior stroke, and 818 patients with a history of transient ischemic attacks (TIA). Functional ability was assessed using scores from the Short Form 12.

The researchers found that physical functioning, and to a lesser extent mental functioning, in patients with stroke symptoms but no diagnosis was worse than in symptom-free subjects and on par with what was noted in TIA patients. As anticipated, stroke patients had the greatest impairments in physical and mental functioning.

The differences between the groups were still apparent after adjusting for demographic variables, vascular risk factors, and health behaviors, and other potential confounders, the authors note.

Symptoms of weakness or numbness were predictive of greater reductions in physical functioning, while difficulties in expression or language comprehension were tied to impairments in mental functioning.

"These results show a need for a greater awareness of stroke symptoms and a need to take these symptoms seriously," Dr. Howard emphasized. "These symptoms could indicate that a person already has had a small stroke, which greatly increases the risk of major stroke."

Stroke 2007;38.

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