| Title: |
Development of a Prognostic Model for Poststroke Dementia Using Multiple International Cohorts |
| Authors: |
Lo, Jessica W.; Crawford, John D.; Desmond, David W.; Godefroy, Olivier; Roussel, Martine; Bordet, Regis; Dondaine, Thibaut; Mendyk, Anne-Marie; Bae, Hee-Joon; Lim, Jae-Sung; Ojagbemi, Akin; Bello, Toyin; Chen, Christopher P. L. H.; Chong, Eddie J.; Venketasubramanian, Narayanaswamy; Klimkowicz-Mrowiec, Aleksandra; Traykov, Latchezar; Mehrabian, Shima; Chung, Chih-Ping; Chi, Nai-Fang; Lau, Gary Kui Kai; Liu, Dillys Xiaodi; Welberry, Heidi; Brodaty, Henry; Sachdev, Perminder S. |
| Contributors: |
Bae, Hee-Joon |
| Publisher Information: |
Lippincott Williams & Wilkins Ltd. |
| Publication Year: |
2026 |
| Collection: |
Seoul National University: S-Space |
| Subject Terms: |
VASCULAR COGNITIVE IMPAIRMENT; PREDICTION MODELS; MILD STROKE; VALIDATION; PROFILE |
| Description: |
Background and ObjectivesDementia risk prediction models developed for the general population perform poorly in stroke cohorts. Existing stroke-specific models are few and limited by short prediction horizons or reliance on neuroimaging. The aim of this study was to develop a clinically practical model for predicting 5-year dementia risk after stroke using commonly available variables and individual participant data from the Stroke and Cognition Consortium (STROKOG).MethodsData were pooled from 12 studies across 10 countries. Dementia was diagnosed mainly by expert panel consensus and algorithmic classification. Fine-Gray subdistribution hazard models estimated dementia probability, accounting for death as a competing event. Candidate predictors included routinely collected baseline clinical and stroke-related variables, selected through backward stepwise elimination. Model performance was evaluated using discrimination (C-index) and calibration for prediction up to 5 years after stroke. Internal-external cross-validation (IECV) assessed generalizability across studies, regions, and study periods.ResultsA total of 2,663 participants (mean age 67.0 years [SD 11.1]; 40% female) were followed for a median of 2.0 years (IQR 1.0-5.0), during which 655 developed dementia (8.7 per 100 person-years). The final model included age, sex, education, history of previous stroke, diabetes, stroke severity, 2 interactions (age x sex; age x stroke severity), and study-level variables including national current health expenditure. An Excel-based risk calculator is available in the Supplement (eAppendix 1). The model demonstrated strong discrimination (C-index: 0.81; 95% CI 0.75-0.87) and excellent calibration in the full data set used for development. In IECV, discrimination was acceptable across individual studies (pooled C-index: 0.70 [0.67-0.73]) and higher in recent (post-2010; 0.79 [0.76-0.82]) and European (0.74 [0.71-0.78]) cohorts. Risks were slightly overestimated in Asian cohorts. Case numbers were too small for ... |
| Document Type: |
article in journal/newspaper |
| Language: |
unknown |
| Relation: |
Neurology, Vol.106 No.3, p. e214574; https://hdl.handle.net/10371/231035; 001661301300001; 249716 |
| DOI: |
10.1212/WNL.0000000000214574 |
| Availability: |
https://hdl.handle.net/10371/231035; https://doi.org/10.1212/WNL.0000000000214574 |
| Accession Number: |
edsbas.6B4640A2 |
| Database: |
BASE |