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 a risk model.
Researchers found that about one in three adults developed dementia after stroke over the long-term. The new tool stratifies people into five different levels of dementia risk after stroke based on underlying health, stroke characteristics and risk factors. Factors linked with a higher risk of developing dementia after 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.
The study used data from the Ontario Stroke Registry, which 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, 13,833 with ischemic stroke and 2,340 with intracerebral hemorrhage. All participants were followed for a diagnosis of dementia through March 2024, with an average follow-up of 7.5 years after stroke.
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 score was derived in the Ontario Stroke Registry and validated in the Ontario Stroke Audit, a separate, randomly selected sample of patients from all hospitals in the province.
According to lead study author Raed A. Joundi, M.D., D.Phil., M.Sc., the goal is to have a practical, bedside tool that can predict dementia risk after a stroke. The 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 focused on reducing the long-term risk of dementia. More information about stroke statistics is available at www.stroke.org.
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. Study authors note that while traditional focus has been on preventing another stroke, dementia is more common than recurrent stroke over the long-term. Healthy lifestyle choices and controlling vascular risk factors can lower the risk of dementia, but new and effective targeted interventions for dementia prevention are needed.
American Stroke Association volunteer expert Deborah A. Levine, M.D., M.P.H., who was not involved in the study, noted that 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 abstract for this research is available in the American Stroke Association International Stroke Conference 2026 Online Program Planner.
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. The study featured in this news release is a research abstract, and findings are considered preliminary until published as a full manuscript in a peer-reviewed scientific journal.
