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).
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.
The analysis found that 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.”
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 at the University of Michigan and was not involved in this study.
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).
According to the American Heart Association’s 2026 Heart Disease and Stroke Statistics, stroke is now the #4 leading cause of death in the U.S. Learn more at www.stroke.org or www.DerrameCerebral.org.
