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Early-onset and delayed-onset poststroke dementia - revisiting the mechanisms
Mok VC, Lam BY, Wong A, Ko H, Markus HS, Wong LK.. Nature reviews. Neurology, 2017-02-17
Topic: Risk, prevention and care in population studies
Incident stroke has long been recognized to cause dementia shortly after the event. Patients who survive stroke without early-onset poststroke dementia (PSD) are at a high risk of developing dementia months to years after the initial stroke incident, which has generated enthusiasm for exploring treatments to prevent delayed-onset PSD in survivors of stroke. However, results from clinical trials completed in the past 10-15 years have been disappointing. In light of these results, the present Review revisits the mechanisms of both early-onset and delayed-onset PSD and proposes preventive strategies and directions for future clinical trials. Early-onset PSD results from a complex interplay between stroke lesion features and brain resilience, whereas delayed-onset PSD is associated mainly with the presence of severe sporadic small vessel disease (SVD), and to a lesser extent with Alzheimer disease pathology or recurrent stroke. As well as preventing stroke and delivering acute stroke treatments to reduce initial brain damage, measures to increase brain resilience could also reduce the risk of developing dementia if an incident stroke occurs. Future efforts to prevent delayed-onset PSD should focus on the study of sporadic SVD and on evaluating whether other strategies, in addition to conventional secondary stroke prevention, are effective in dementia prevention in this high-risk group.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Mok, V. C., Lam, B. Y., Wong, A., Ko, H., Markus, H. S., & Wong, L. K. (2017). Early-onset and delayed-onset poststroke dementia - revisiting the mechanisms. Nature reviews. Neurology. https://doi.org/10.1038/nrneurol.2017.16
Vancouver
Mok VC, Lam BY, Wong A, Ko H, Markus HS, Wong LK. Early-onset and delayed-onset poststroke dementia - revisiting the mechanisms. Nature reviews. Neurology. 2017. doi:10.1038/nrneurol.2017.16. PMID: 28211452.
BibTeX
@article{mok2017-28211452,
author = {Mok, V. C. and Lam, B. Y. and Wong, A. and Ko, H. and Markus, H. S. and Wong, L. K.},
title = {{Early-onset and delayed-onset poststroke dementia - revisiting the mechanisms}},
journal = {Nature reviews. Neurology},
year = {2017},
doi = {10.1038/nrneurol.2017.16},
pmid = {28211452},
url = {https://doi.org/10.1038/nrneurol.2017.16}
}
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Key findings
- However, results from clinical trials completed in the past 10-15 years have been disappointing.
- In light of these results, the present Review revisits the mechanisms of both early-onset and delayed-onset PSD and proposes preventive strategies and directions for future clinical trials.
- Early-onset PSD results from a complex interplay between stroke lesion features and brain resilience, whereas delayed-onset PSD is associated mainly with the presence of severe sporadic small vessel disease (SVD), and to a lesser extent with Alzheimer disease pathology or recurrent stroke.
Why it matters
This review notes that clinical trials to prevent delayed-onset poststroke dementia over the past 10 to 15 years have been disappointing, and that delayed-onset cases are associated mainly with severe sporadic small vessel disease. It proposes future research directions rather than reporting an effective prevention.
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Study details
- Evidence strengthLow
How this study scored 45/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Nature reviews. Neurology) |
| Journal's citation record | 3 / 4 | Nature Reviews Neurology: journal h-index 269 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2017 — within 10 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 159 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 14.5 citations a year over 11 year(s) since 2017 |
| Impact for its field and year | 2 / 6 | Cited 2.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 9 other studies in this library |
| Still being cited | 2 / 4 | Cited 38 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Ka Sing Wong: h-index 89 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Cambridge: institution h-index 1,973 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 3 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 28211452) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 45 / 100 | — |
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