Unravelling the nexus of stroke and dementia: Deciphering the role of secondary neurodegeneration in orchestrating cognitive decline

Yeah, we've known of the dementia risk post stroke a long time. WHOM will do the research that prevents that problem? Since incompetency has reigned for over a decade, I don't expect any help in the near future until we get survivors in charge.

1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.

2. Then this study came out and seems to have a range from 17-66%. December 2013.`    

3. A 20% chance in this research.   July 2013.

4. Dementia Risk Doubled in Patients Following Stroke September 2018

5. Brain Bleeds Double Dementia Risk February 2025

6. Developing Dementia After Stroke: What Is the Risk for Stroke Survivors?

 March 2025

The latest here:

 Unravelling the nexus of stroke and dementia: Deciphering the role of secondary neurodegeneration in orchestrating cognitive decline

Received: 25 October 2024 | Revised: 8 December 2024 | Accepted: 20 December 2024

DOI: 10.1002/nep3.74

R E V I E W

Unravelling the nexus of stroke and dementia:

Deciphering the role of secondary neurodegeneration

in orchestrating cognitive decline

Shannon M. Stuckey1 | Rebecca J. Hood 1 | Lin Kooi Ong2 |

Isabella M. Bilecki1 | Lyndsey E. Collins‐Praino 1 | Renée J. Turner1

1

Discipline of Anatomy and Pathology, School

of Biomedicine, Faculty of Health and Medical

Sciences, The University of Adelaide,

Adelaide, Australia

2

School of Health and Medical Sciences &

Centre for Health Research, University of

Southern Queensland, Toowoomba,

Queensland, Australia

Correspondence

Shannon M. Stuckey, Discipline of Anatomy

and Pathology, School of Biomedicine,

Faculty of Health and Medical Sciences,

The University of Adelaide, Adelaide 5005,

Australia.

Email: shannon.stuckey@adelaide.edu.au

Managing Editor: Lili Wang/Ningning Wang

Funding information

Perpetual; Neurosurgical Research

Foundation

Abstract

Stroke is the leading cause of acquired disability. The development of acute

ischemic stroke treatments, such as mechanical thrombectomy and tissue

plasminogen activator, has resulted in more patients surviving the initial

insult. However, long‐term complications, such as post‐stroke cognitive

impairment (PSCI) and dementia (PSD), are at an all‐time high. Notably,

80% of stroke survivors suffer from cognitive impairment, and a history of

stroke doubles a patient's lifetime risk of developing dementia. A combi-

nation of greater life expectancy, an increase in the number of strokes in

young individuals, and improved survival have inherently increased the

number of years patients are living post‐stroke, highlighting the critical need

to understand the long‐term effects of stroke, including how pathological

changes in the brain might give rise to functional and behavioral changes in

stroke survivors. Even with this increased risk of PSCI and PSD in stroke

survivors, understanding of how the stroke itself develops into these con-

ditions remains incomplete. Recently, secondary neurodegeneration (SND)

following stroke has been linked with PSCI and PSD. SND is the degen-

eration of brain regions outside the original stroke site. Degeneration in

these sites is thought to arise due to functional diaschisis with the infarct

core; however, observation of SND pathology in multiple regions without

direct connectivity to the stroke infarct suggests that the degeneration in

these regions is likely more complex. Moreover, pathological hallmarks of

dementia, such as a deposition of neurodegenerative proteins and iron, cell

death, inflammation and blood–brain barrier alterations, have all been found

in regions such as the thalamus, hippocampus, basal ganglia, amygdala

and prefrontal cortex following stroke. Hence, in this review, we present the

current understanding of PSCI and PSD in the context of SND and outline

how remote anatomical and molecular changes may drive the development

of these conditions.