Project Overview

Stroke is a common and disabling brain disorder which may have long-lasting effects. One of the most feared consequences is the development of cognitive decline and dementia after stroke. Post-stroke dementia (PSD) leads to a loss of independence and quality of life as well as earlier death. Unfortunately, very little is known about PSD, including its frequency and predictors, and without this knowledge we cannot develop strategies to prevent it. Studies so far have been small or have only included a limited number of factors. Our novel study, INTREPID, will provide key insights into PSD by studying the entire Ontario population with linked databases. First, we will determine the number of dementia events occurring after stroke by age group, sex, and disability. Secondly, we will evaluate all possible factors that may impact PSD, from patient factors like stroke severity, co-morbidities, and depression, to hospital treatment factors, to medications, to recurrent strokes and other hospitalizations, to socioeconomic factors like education and income, and lastly to complex environmental factors like community walkability and pollution. This comprehensive approach will consider a wide number of factors, many previously understudied (or not studied) which may impact PSD. A particularly unique contribution will be evaluating the impact of socioeconomic status and the environment on PSD. Lastly, we will take the analysis a step further and develop a score which can predict PSD at various timeframes after stroke. Our score will allow us to predict future development of PSD, which will be key in care planning as well as in selecting individuals who are candidates for novel therapies and clinical trials. Our statistical methods will take into account the complexity of PSD and all its potential contributors. These results will be fundamental in building future prospective studies in PSD, planning clinical trials, and designing public health measures. Overall, INTREPID will be a major leap forward in understanding PSD and uncovering potential approaches to prevent PSD or reduce its impact.

Principal Investigator

Raed Joundi , McMaster University

Partners and Donors

Canadian Stroke Consortium

Heart and Stroke Foundation of Canada