Incidence and Prognostic Indicators of Dementia After Stroke and Covert Brain Infarction

Journal of the American Heart Association, Volume 15, Issue 6 , March 17, 2026. BackgroundCognitive impairment is common after transient ischemic attack (TIA) and stroke, but contemporary population‐representative estimates of dementia risk after stroke are scarce, particularly in view of stroke severity and competing risk of mortality.MethodsWe included individuals from the population‐based Rotterdam Study with first‐ever covert brain infarction (n=630), TIA (n=547), minor stroke (National Institutes of Health Stroke Scale score <4; n=392), or major stroke (National Institutes of Health Stroke Scale score ≥4; n=493) between 2002 and 2018, and matched those 1:3 to reference participants on age and sex.

We determined 10‐year dementia risks by event severity, comparing cause‐specific and subdistribution hazards models to account for competing risk of death, and explored prognostic indicators of dementia after TIA and stroke.ResultsOf 1431 patients with first‐ever TIA or stroke (mean age 75.2 years, 58.3% women), 161 had pre‐event dementia and 205 developed dementia during a median follow‐up of 6.1 years. After 10 years, 59.4% of patients had died, with highest risk in the first months after major stroke.