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Stroke–heart syndrome and risk of incident dementia among patients with first‐ever ischemic stroke: A territory‐wide population‐based cohort study
Christopher Tze‐Wei Tsang, Sylvia E. Choi, Tommaso Bucci, Alfred C. W. Lau, Q W Ren, Jiayi Huang, Mei‐Zhen Wu, Wenli Gu et al.. Alzheimer s & Dementia, 2025-09-01
Topic: Risk, prevention and care in population studies
Of the 130,605 included patients with ischemic stroke, 12,696 (9.7%) patients developed SHS. Patients with SHS had a 19% increased risk of dementia compared to those without SHS at 1 year post-stroke, driven mainly by vascular dementia. This increased risk gradually declined and became non-significant after 3 years post-stroke. Appropriate antithrombotic therapy and comorbidities optimization were associated with a 32% reduced dementia risk in patients with SHS. SHS is associated with an increased risk of incident dementia. Appropriate antithrombotic therapy and comorbidities optimization post-stroke may reduce this heightened risk of cognitive impairment. HIGHLIGHTS: Association between stroke-heart syndrome (SHS) and dementia was evaluated in a population-based cohort. Development of SHS associated with a 19% increased 1 year risk of dementia. The increased risk of dementia gradually declined with each year of follow-up. Integrated post-stroke management may reduce this heightened risk of cognitive impairment.
Key findings
- Of the 130,605 included patients with ischemic stroke, 12,696 (9.7%) patients developed SHS.
- Patients with SHS had a 19% increased risk of dementia compared to those without SHS at 1 year post-stroke, driven mainly by vascular dementia.
- This increased risk gradually declined and became non-significant after 3 years post-stroke.
- Appropriate antithrombotic therapy and comorbidities optimization were associated with a 32% reduced dementia risk in patients with SHS.
- SHS is associated with an increased risk of incident dementia.
Why it matters
Among people who had a first ischemic stroke, those who also developed stroke-heart syndrome had a 19% higher risk of dementia at one year, mainly vascular dementia, and this raised risk faded and became non-significant after three years. Appropriate antithrombotic therapy and management of other conditions were linked to a 32% lower dementia risk in these patients.
Study details
- Effect size9.7%
- Evidence strengthModerate
How this study scored 43/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, 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 (Alzheimer s & Dementia) |
| Journal's citation record | 2 / 4 | Alzheimer s & Dementia: journal h-index 228 (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 | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| 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 | 1 / 7 | Cited 4 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 2 / 6 | Cited 2.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 4 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Kai‐Hang Yiu: h-index 44 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Sapienza University of Rome: institution h-index 1,145 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 12 institution(s) in 7 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40965281) |
| Free to read | 2 / 2 | Free to read |
| Total | 43 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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
Tsang, C. T., Choi, S. E., Bucci, T., Lau, A. C. W., Ren, Q. W., Huang, J., et al. (2025). Stroke–heart syndrome and risk of incident dementia among patients with first‐ever ischemic stroke: A territory‐wide population‐based cohort study. Alzheimer s & Dementia. https://doi.org/10.1002/alz.70716
Vancouver
Tsang CT, Choi SE, Bucci T, Lau ACW, Ren QW, Huang J, et al. Stroke–heart syndrome and risk of incident dementia among patients with first‐ever ischemic stroke: A territory‐wide population‐based cohort study. Alzheimer s & Dementia. 2025. doi:10.1002/alz.70716. PMID: 40965281.
BibTeX
@article{tsang2025-40965281,
author = {Tsang, Christopher Tze‐Wei and Choi, Sylvia E. and Bucci, Tommaso and Lau, Alfred C. W. and Ren, Q W and Huang, Jiayi and Wu, Mei‐Zhen and Gu, Wenli and others},
title = {{Stroke–heart syndrome and risk of incident dementia among patients with first‐ever ischemic stroke: A territory‐wide population‐based cohort study}},
journal = {Alzheimer s \& Dementia},
year = {2025},
doi = {10.1002/alz.70716},
pmid = {40965281},
url = {https://doi.org/10.1002/alz.70716}
}
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