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From the Neurovascular Service (Dr. Johnston), Department of Neurology, University of California, San Francisco; Department of Neurology (Dr. Fayad), University of Nebraska, Omaha; Department of Neurologic Sciences (Dr. Gorelick), Rush Medical College, Chicago, IL; Department of Neurology (Dr. Hanley), Johns Hopkins Medical Center, Baltimore, MD; and National Stroke Association (P. Shwayder, D. van Husen, and T. Weiskopf), Englewood, CO.
Address correspondence and reprint requests to Dr. S. Claiborne Johnston, Department of Neurology, Box 0114, University of California, San Francisco, 505 Parnassus Ave., M-798, San Francisco, CA 94143-0114; e-mail: clay.johnston{at}ucsfmedctr.org
Background: Little information is available about public knowledge of TIA and prevalence of a TIA diagnosis.
Methods: The National Stroke Association sponsored a telephone survey by single-stage random-digit dialing of noninstitutionalized US residents 
18 years old, which was conducted in 1999. Demographic characteristics of participants were compared to the US population to produce weights for projections. Independent predictors of knowledge and diagnosis of TIA were determined by including all demographic characteristics in logistic regression models.
Results: Among 10,112 participants, 2.3% reported having been told by a physician that they had a TIA. Older age, lower income, and fewer years of education were independently associated with a diagnosis of TIA. Of those with TIA, only 64% saw a physician within 24 hours of the event. A physician diagnosis of stroke was reported by 2.3% of participants, of whom 19% recalled having had a TIA before the stroke. An additional 3.2% of participants recalled symptoms consistent with TIA but did not seek medical attention. Only 8.2% correctly related the definition of TIA and 8.6% could identify a typical symptom. Men, nonwhites, and those with lower income and fewer years of education were less likely to be knowledgeable about TIA.
Conclusions: An estimated 4.9 million people in the US report a diagnosis of TIA, and many more recall symptoms consistent with TIA but do not seek medical attention. Reducing stroke risk after TIA could have substantial impact on public health but will require public education about the importance of having stroke symptoms evaluated, even if they resolve.
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