- 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.
- 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.
- Knowing the risk of developing dementia after a stroke can help
researchers design better clinical trials and interventions. It can also
guide the recruitment of patients who are eligible to participate in
efforts to lower the risk of dementia.
- Note: The study featured in this news release is a research abstract. Abstracts
presented at the American Heart Association/American Stroke
Association’s scientific meetings are not peer-reviewed, and the
findings are considered preliminary until published as a full manuscript
in a peer-reviewed scientific journal.
Embargoed until 4 a.m. CT/5 a.m. ET, Thursday, Jan. 29, 2026
DALLAS, Jan. 29, 2026 — A new risk calculator accurately estimated the likelihood of adults developing dementia within ten years after a stroke, according to a preliminary study to be presented at the American Stroke Association’s International Stroke Conference 2026.
The meeting is in New Orleans, Feb. 4-6, 2026, and is a world premier
meeting for researchers and clinicians dedicated to the science of
stroke and brain health.
According to researchers, people with stroke and transient ischemic attack (TIA) are at high risk of subsequent dementia, but prediction tools for dementia are lacking.
“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 in the department of medicine at McMaster
University, a stroke neurologist at Hamilton Health Sciences, a
scientist at the Population Health Research Institute, all in Hamilton,
Ontario, Canada, and an adjunct scientist at ICES Central in Toronto
(where the statistical analysis was done).
“The goal is to have a practical, bedside tool that can predict
dementia risk after a stroke. Our tool predicts dementia rates that are
very close to the observed rates and may help to enroll high-risk
patients who have had transient ischemic attack, ischemic stroke or intracerebral hemorrhage in clinical trials that are focused on reducing the long-term risk of dementia.”
Researchers examined health records for nearly 50,000 adults
hospitalized with stroke to create and validate a risk model to estimate
which stroke survivors have the highest risk of developing dementia.
The data from the Ontario Stroke Registry included hospital admissions
due to stroke between 2002 and 2013 in Canada. Study participants drawn
from the registry for derivation of the risk score included 7,554 adults
with transient ischemic attack (TIA), 13,833 with ischemic stroke and
2,340 with intracerebral hemorrhage. The participants were discharged
from the hospital without a diagnosis of dementia, and all were followed
for a diagnosis of dementia through March 2024 (average of 7.5 years
after stroke) based on administrative health data.
Researchers examined the rates of dementia calculated by the new tool
and compared them to the observed rates of dementia. The score was
derived in the Ontario Stroke Registry (11 regional stroke centers) and
validated in the Ontario Stroke Audit, a separate, randomly selected
sample of patients from all hospitals in the province.
The analysis found:
- For people who had a transient ischemic attack, the top factors
associated with increased dementia risk were older age, needing help
with activities of daily living prior to TIA, having diabetes,
depression, cognitive symptoms on presentation (such as memory, judgment
or attention) and any disability at hospital discharge.
- The main risk factors associated with developing dementia for
people with stroke were being older, being female, having diabetes,
depression, intracerebral hemorrhage (compared to ischemic stroke),
cognitive symptoms during hospitalization or greater disability at
hospital discharge.
- The risk calculator used the top risk factors for dementia to
categorize individuals into different levels of estimated risk over the
next 10 years after a stroke. Those in the highest category of estimated
risk had a 50% probability of dementia over 10 years, versus
participants in the lowest category of risk who had a 5% probability of
dementia.
The study authors note that the current focus of the dementia risk
prediction tool is to stratify patients into different levels of risk
for research studies and clinical trials of dementia prevention, rather
than clinical decision-making or treatment.
“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.
Healthy lifestyle choices and controlling vascular risk factors can
lower the risk of dementia, but we need new and effective targeted
interventions for dementia prevention.”
Study limitations include that data were not available about the type
of dementia that may develop. Researchers did not have access to
imaging scans of the study participants, which would offer more detailed
information about their stroke location and size or the presence of
covert infarcts (small ischemic brain lesions).
American Stroke Association volunteer expert, Deborah A. Levine,
M.D., M.P.H., said, “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.” Levine is a professor of internal medicine and
neurology, the departments of internal medicine and neurology, the
Cognitive Health Services Research and Stroke Programs and the Institute
for Healthcare Policy and Innovation at the University of Michigan.
Levine was not involved in this study.
Study details, background and design:
- The average age of all participants was 70; 53% of participants were men, and 47% women.
- Using the new risk predictor tool, researchers calculated 1-, 5-
and 10-year dementia risk scores, and participants were divided into
five groups, ranging from the lowest to the highest risk, based on the
risk factors that were present. The risk calculator evaluated the number
and the degree of each factor’s contribution to dementia risk,
resulting in a composite score that indicates the likelihood of
developing dementia in the future.
- Researchers identified risk factors and other characteristics, such
as age, diabetes status, depression, disability and sex, then divided
patients into five categories of dementia risk based on these risk
factors.
- To validate the results, researchers reviewed data on a similar
number of stroke admissions from the Ontario Stroke Audit. Dementia risk
scores were calculated separately for participants who had a transient
ischemic attack vs. a stroke.
- This tool, used prior to discharge from the hospital, has the
potential to help physicians assess whether patients might develop
long-term dementia.
Co-authors, disclosures and funding sources are listed in the abstract.
Statements and conclusions of studies that are presented at the
American Heart Association/American Stroke Association’s scientific
meetings are solely those of the study authors and do not necessarily
reflect the Association’s policy or position. The Association makes no
representation or guarantee as to their accuracy or reliability.
Abstracts presented at the Association’s scientific meetings are not
peer-reviewed, rather, they are curated by independent review panels and
are considered based on the potential to add to the diversity of
scientific issues and views discussed at the meeting. The findings are
considered preliminary until published as a full manuscript in a
peer-reviewed scientific journal.
The Association receives more than 85% of its revenue from sources
other than corporations. These sources include contributions from
individuals, foundations and estates, as well as investment earnings and
revenue from the sale of our educational materials. Corporations
(including pharmaceutical, device manufacturers and other companies)
also make donations to the Association. The Association has strict
policies to prevent any donations from influencing its science content
and policy positions. Overall financial information is available here.
Additional Resources:
Takashi Shimoyama
Yoichiro Kamatani
Koichi Matsuda3†