A new risk prediction tool can accurately identify stroke survivors with the highest risk for developing dementia within a decade of having a stroke, according to a large Canadian study. The research, to be presented at the American Stroke Association’s International Stroke Conference 2026, analyzed health records for nearly 50,000 adults hospitalized with stroke to create and validate the model.
This development is significant because dementia is a common and serious consequence of stroke, yet effective prediction tools have been lacking. Lead study author Raed A. Joundi, M.D., D.Phil., M.Sc., noted that about one in three adults develops dementia after stroke over the long term. The new tool stratifies people into five different levels of dementia risk based on underlying health, stroke characteristics, and risk factors. For those in the highest risk category, the probability of dementia over ten years is 50%, compared to just 5% for those in the lowest category.
The tool's primary immediate application is for research. Knowing a patient's risk can help researchers design better clinical trials and interventions and guide the recruitment of eligible patients for studies focused on lowering dementia risk. "The goal is to have a practical, bedside tool that can predict dementia risk after a stroke," Joundi said. "Our tool predicts dementia rates that are very close to the observed rates and may help to enroll high-risk patients... in clinical trials that are focused on reducing the long-term risk of dementia."
Researchers identified key factors linked to a higher risk of post-stroke dementia. For all stroke types, these included older age, diabetes, depression, cognitive symptoms during hospitalization, and greater disability at discharge. Specific factors for those who had a transient ischemic attack included needing help with daily activities prior to the event. For stroke patients, being female and having an intracerebral hemorrhage, compared to an ischemic stroke, were additional risk factors.
The implications for patient care and research are substantial. American Stroke Association volunteer expert Deborah A. Levine, M.D., M.P.H., who was not involved in the study, stated, "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." The tool could eventually help physicians assess long-term dementia risk prior to a patient's hospital discharge.
However, the study authors caution that the tool is currently focused on stratifying patients for research rather than for direct clinical decision-making. Study limitations include a lack of data on the specific type of dementia that may develop and no access to brain imaging scans for more detailed analysis. The findings are also considered preliminary until published as a full manuscript in a peer-reviewed scientific journal, as is standard for abstracts presented at scientific meetings.
The research underscores a shift in post-stroke care priorities. "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," Joundi explained. "Over the long-term, dementia is more common than a recurrent stroke." The development of this risk calculator is a step toward enabling that focus, potentially accelerating the discovery of targeted interventions to prevent dementia in the vulnerable population of stroke survivors.
