A new risk prediction tool accurately identified stroke survivors with the highest risk for developing dementia within a decade after a stroke, according to a large study in Canada. The findings, considered preliminary until published in a peer-reviewed journal, were presented at the American Stroke Association’s International Stroke Conference 2026.
Researchers used health records from the Ontario Stroke Registry, including over 23,000 adults hospitalized with transient ischemic attack (TIA), ischemic stroke, or intracerebral hemorrhage between 2002 and 2013. Participants were discharged without dementia and followed for an average of 7.5 years. The tool categorized individuals into five risk levels based on factors like age, diabetes, depression, disability before and after stroke, cognitive symptoms during hospitalization, and stroke type.
Those in the highest risk category had a 50% probability of dementia over 10 years, compared to 5% for the lowest risk group. Lead author Dr. Raed A. Joundi from McMaster University emphasized that the tool is designed for research, not clinical decision-making, stating, “The goal is to have a practical, bedside tool that can predict dementia risk after a stroke.” The study builds on prior research showing about 1 in 3 adults develop dementia after stroke long-term.
Key risk factors for dementia after stroke included older age, diabetes, depression, cognitive symptoms, and greater disability at discharge. For TIA, factors included older age, pre-TIA disability, diabetes, depression, cognitive symptoms, and post-TIA disability. The tool was validated in a separate sample from the Ontario Stroke Audit.
Dr. Deborah A. Levine, an American Stroke Association volunteer expert, noted, “Dementia after a stroke is very difficult for patients and their loved ones,” adding that the tool could accelerate research for new treatments. Limitations include lack of data on dementia type and absence of imaging for stroke location or size. The study was funded by sources listed in the abstract, and the American Heart Association received no corporate funding for the research.
Stroke is now the #4 leading cause of death in the U.S., according to the American Heart Association’s 2026 Heart Disease and Stroke Statistics. The new risk tool may help enroll high-risk patients in clinical trials focused on reducing dementia risk, as highlighted by Joundi: “We need new and effective targeted interventions for dementia prevention.”
