A new risk prediction tool was able to accurately identify stroke survivors with the highest risk for developing dementia within a decade of having a stroke, according to a large study in Canada. The findings, presented at the American Stroke Association’s International Stroke Conference 2026, could help researchers design better clinical trials and interventions by guiding the recruitment of high-risk patients.
Researchers examined health records for nearly 50,000 adults hospitalized with stroke between 2002 and 2013 in the Ontario Stroke Registry. The study included 7,554 adults with transient ischemic attack (TIA), 13,833 with ischemic stroke and 2,340 with intracerebral hemorrhage. Participants were discharged without a dementia diagnosis and followed through March 2024 (average of 7.5 years). The risk score was derived and validated using separate cohorts.
Factors linked with a higher risk of developing dementia after a stroke included being older, having any disability before the stroke, having a higher level of disability after the stroke, having an intracerebral hemorrhage (compared to an ischemic stroke), having diabetes, experiencing cognitive symptoms during hospitalization or suffering from depression. For TIA patients, key factors included older age, needing help with daily activities prior to TIA, diabetes, depression, cognitive symptoms on presentation, and any disability at discharge.
“Our previous research found that about 1 in 3 adults developed dementia after stroke over the long-term. We created a new tool that can stratify people into five different levels of dementia risk after stroke based on underlying health, stroke characteristics and risk factors,” said lead study author Raed A. Joundi, M.D., D.Phil., M.Sc., an assistant professor at McMaster University and a stroke neurologist at Hamilton Health Sciences.
The risk calculator categorized individuals into five risk levels. Those in the highest category had a 50% probability of dementia over 10 years, versus participants in the lowest category who had a 5% probability. The tool aims to enroll high-risk patients in clinical trials focused on reducing long-term dementia risk.
“Dementia is a serious condition that commonly occurs in the aftermath of a stroke,” Joundi said. “While our traditional focus has been on preventing another stroke, which is very important, we need to pay more attention to the development of dementia and how to prevent it. Over the long-term, dementia is more common than a recurrent stroke.”
American Stroke Association volunteer expert Deborah A. Levine, M.D., M.P.H., noted, “Dementia after a stroke is very difficult for patients and their loved ones, and there aren’t enough effective treatments to help. This well-done study provides a useful tool that could make research faster, so new treatments can get to stroke survivors sooner.”
Study limitations include lack of data on dementia type and absence of imaging scans for stroke location or size. The findings are considered preliminary until published in a peer-reviewed journal. Additional resources and the full abstract are available at the American Heart Association newsroom.
