Delayed-onset dementia after stroke or transient ischemic attack
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Patients surviving stroke without immediate dementia are at high risk of delayed-onset dementia. Mechanisms underlying delayed-onset dementia are complex and may involve vascular and/or neurodegenerative diseases.


Dementia-free patients with stroke and/or transient ischemic attack (TIA; n = 919) were studied for 3 years prospectively, excluding those who developed dementia 3 to 6 months after stroke and/or TIA.


Forty subjects (4.4%) developed dementia during the study period. Imaging markers of severe small vessel disease (SVD), namely presence of ≥3 lacunes and confluent white matter changes; history of hypertension and diabetes mellitus independently predicted delayed-onset dementia after adjustment for age, gender, and education. Only 6 of 31 (19.4%) subjects with delayed cognitive decline harbored Alzheimer's disease–like Pittsburg compound B (PiB) retention. Most PiB cases (16/25, 64%) had evidence of severe SVD.


Severe SVD contributes importantly to delayed-onset dementia after stroke and/or TIA. Future clinical trials aiming to prevent delayed-onset dementia after stroke and/or TIA should target this high-risk group.
All Author(s) ListMOK Chung Tong Vincent, LAM Bonnie Yin Ka, WANG, Zhaolu, LIU Wenyan, AU Wing Chi Lisa, LEUNG Eric, CHEN Sirong, YANG Jie, CHU Chiu Wing Winnie, LAU Yuk Lun Alexander, CHAN Yin Yan Anne, SHI Lin, FAN Sy Florence, MA Sze Ho, IP Yuet Wah, SOO Oi Yan, LEUNG Wai Hong Thomas, KWOK Chi Yui Timothy, HO H Chi, WONG Ka Sing Lawrence, WONG Adrian
Journal nameAlzheimer's and Dementia
Volume Number12
Issue Number11
Pages1167 - 1176
LanguagesEnglish-United Kingdom
KeywordsDelayed-onset dementia, Stroke, Transient ischemic attack, Small vessel disease, Alzheimer's disease

Last updated on 2021-20-02 at 00:56