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Stroke, Cardiovascular Disease, and Dementia After Hospitalized TIA
Kamakshi Lakshminarayan, Faye L. Norby, Ching-Ping Hong, A.R. Folsom, Wayne D. Rosamond, Rebecca F. Gottesman, Silvia Koton, James Russell Pike et al.. Neurology, 2025-09-04
Topic: Risk, prevention and care in population studies
The ARIC study enrolled 15,792 participants (27% Black) aged 45-64 years. Our analytic sample included 13,721 participants (mean age 54 years, 55.5% women) who were without history of hospitalized TIAs or the outcomes of interest at baseline. There were 536 hospitalized TIAs over a median of 29 years. Incident dementia risk almost doubled after TIA (hazard ratio [HR] 1.96; 95% CI 1.66-2.31). Participants who had a TIA were at high risk of stroke (8.14; 6.87-9.64) and CVD (1.52; 1.28-1.82) compared with those without a TIA. They were also at an elevated risk of all-cause mortality (HR 1.55; 95% CI 1.39-1.73) and CVD mortality (1.82; 1.48-2.22). A sensitivity analysis restricted to participants with TIAs but without stroke showed an elevated risk of dementia (HR 1.67; 95% CI 1.37-2.03). We report an increased risk of dementia after TIA in our multidecade cohort. The elevated risk was present after elimination of stroke as an intermediary variable. Consistent with other studies, we found an increased risk of stroke, CVD, and mortality after TIA. The clinical implications of these results are that in addition to vascular risk factor modification, clinicians should consider incorporating cognitive screening into post-TIA follow-up care.
Key findings
- The ARIC study enrolled 15,792 participants (27% Black) aged 45-64 years.
- Our analytic sample included 13,721 participants (mean age 54 years, 55.5% women) who were without history of hospitalized TIAs or the outcomes of interest at baseline.
- There were 536 hospitalized TIAs over a median of 29 years.
- Incident dementia risk almost doubled after TIA (hazard ratio [HR] 1.96; 95% CI 1.66-2.31).
- Participants who had a TIA were at high risk of stroke (8.14; 6.87-9.64) and CVD (1.52; 1.28-1.82) compared with those without a TIA.
Why it matters
In the ARIC cohort, people who had a hospitalized transient ischemic attack had nearly double the risk of later dementia, and this elevated risk remained after excluding stroke as an intermediary. The authors suggest cognitive screening in post-TIA follow-up, but the study does not test a treatment or cure.
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Study details
- Participants15,792
- Effect size55.5%; HR 1.55; HR 1.67
- Evidence strengthModerate
How this study scored 60/100
Published in a leading specialty journal. Scored zero for study design and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Neurology) |
| Journal's citation record | 4 / 4 | Neurology: journal h-index 525 (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 | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 4 / 4 | 15,792 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 6 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 2.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 3.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 1 / 4 | Cited 6 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Pamela L. Lutsey: h-index 79 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | National Institutes of Health: institution h-index 2,723 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 6 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40906979) |
| Free to read | 2 / 2 | Free to read |
| Total | 60 / 100 | — |
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Read the original
- DOI: 10.1212/wnl.0000000000214020
- PubMed: 40906979
- Original source →
- Free full text: PubMed Central →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Lakshminarayan, K., Norby, F. L., Hong, C.-P., Folsom, A., Rosamond, W. D., Gottesman, R. F., et al. (2025). Stroke, Cardiovascular Disease, and Dementia After Hospitalized TIA. Neurology. https://doi.org/10.1212/wnl.0000000000214020
Vancouver
Lakshminarayan K, Norby FL, Hong C.-P, Folsom A, Rosamond WD, Gottesman RF, et al. Stroke, Cardiovascular Disease, and Dementia After Hospitalized TIA. Neurology. 2025. doi:10.1212/wnl.0000000000214020. PMID: 40906979.
BibTeX
@article{lakshminarayan2025-40906979,
author = {Lakshminarayan, Kamakshi and Norby, Faye L. and Hong, Ching-Ping and Folsom, A.R. and Rosamond, Wayne D. and Gottesman, Rebecca F. and Koton, Silvia and Pike, James Russell and others},
title = {{Stroke, Cardiovascular Disease, and Dementia After Hospitalized TIA}},
journal = {Neurology},
year = {2025},
doi = {10.1212/wnl.0000000000214020},
pmid = {40906979},
url = {https://doi.org/10.1212/wnl.0000000000214020}
}
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