A new risk prediction tool may help identify stroke survivors at the highest risk of developing dementia within a decade, according to a preliminary study presented at the American Stroke Association’s International Stroke Conference 2026. The tool, developed using data from nearly 50,000 adults in Canada, stratifies patients into five risk categories, with the highest group facing a 50% probability of dementia over 10 years, compared to just 5% in the lowest group.
“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 at McMaster University and stroke neurologist at Hamilton Health Sciences. The goal, he noted, is to provide a practical bedside tool that can predict dementia risk accurately and help enroll high-risk patients in clinical trials focused on reducing long-term dementia.
Researchers examined health records from the Ontario Stroke Registry, including hospital admissions for transient ischemic attack (TIA), ischemic stroke, or intracerebral hemorrhage between 2002 and 2013. Participants were followed for dementia diagnosis through March 2024, with an average follow-up of 7.5 years. Key risk factors identified included older age, pre-stroke disability, diabetes, depression, cognitive symptoms during hospitalization, and greater post-stroke disability. For TIA patients, factors like needing help with daily activities prior to the event also elevated risk.
The tool was validated in a separate sample from the Ontario Stroke Audit, showing strong agreement between predicted and observed dementia rates. “Dementia is a serious condition that commonly occurs in the aftermath of a stroke,” Joundi said. “Over the long-term, dementia is more common than a recurrent stroke. Healthy lifestyle choices and controlling vascular risk factors can lower the risk, but we need new effective targeted interventions.”
American Stroke Association volunteer expert Deborah A. Levine, M.D., M.P.H., of the University of Michigan, called the tool promising: “Dementia after a stroke is very difficult for patients and their loved ones, and there aren’t enough effective treatments. This well-done study provides a useful tool that could make research faster, so new treatments can get to stroke survivors sooner.”
The study is considered preliminary until published in a peer-reviewed journal. However, the tool’s ability to stratify risk could significantly aid in designing prevention trials and targeting high-risk individuals. For more information on stroke and brain health, visit the American Stroke Association or American Heart Association.
