In Brief | Risk factors for cognitive impairment and dementia after stroke: a systematic review and meta-analysis

Originally published in the Lancet Healthy Longevity


This study, a systematic review and meta-analysis, examined the risk factors for post-stroke cognitive impairment (PSCI) and dementia (PSD).

The systematic review identified 113 articles (89 studies, 160,783 patients) for meta-analysis. Various study types were included, assessing associations between baseline risk factors and PSCI or PSD over a minimum 3-month follow-up.

The researchers recorded that baseline cognitive impairment posed the highest risk for post-stroke cognitive impairment (PSCI) and dementia (PSD). Treatable risk factors for PSCI included diabetes, atrial fibrillation, moderate or severe white matter hyperintensities (WMH), and WMH severity. For PSD, diabetes, moderate or severe WMH, and WMH severity were treatable risk factors.

Other risk factors included lower education, previous stroke, left hemisphere stroke, three or more lacunes, brain atrophy, and low baseline functional status. Associations with PSD weakened in more recent studies. Substantial heterogeneity and evidence of reporting bias were observed.

The study emphasizes the significance of cognitive impairment shortly after a stroke for predicting long-term post-stroke cognitive impairment (PSCI) and dementia (PSD). Treatable risk factors identified include diabetes, atrial fibrillation, and indicators of cerebral small vessel disease like white matter hyperintensities and lacunes. The findings suggest potential targets for preventing PSCI and PSD in future trials.


Access the original article

Filler, J., Georgakis, M. K., & Dichgans, M. (2024). Risk factors for cognitive impairment and dementia after stroke: a systematic review and meta-analysis. The lancet. Healthy longevity, 5(1), e31–e44. https://doi.org/10.1016/S2666-7568(23)00217-9

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