Reza Hosseini Ghomi: A New Tool Predicts The Onset of Dementia After Stroke

Reza Hosseini Ghomi, Chief Executive Officer of MedFlow, shared on LinkedIn:

”Had a stroke? Your dementia risk just tripled.

New tool predicts exactly when.

International Stroke Conference this week:

45,000 stroke patients tracked 8.4 years
New prediction model
Better accuracy than existing tools

Why matters:

1 in 4 stroke survivors develops dementia
Most within 5 years
Early intervention works
Nobody’s screening

The tool:

Models for ischemic stroke, hemorrhagic stroke, TIA
Predicts risk at 1, 3, 5, 10 years

Inputs: Age, stroke type, severity, vascular risks, recurrent strokes
Output: Individual risk percentage, risk category, timeline

Why stroke causes dementia:

Direct brain damage, vascular cascade, inflammation spreads.

Most survivors don’t know this risk.

Current care after stroke:

• Physical therapy: Yes
• Speech therapy: Yes
• Cardiac risk reduction: Yes
• Cognitive screening: Rarely
• Dementia prevention: Almost never

The gap:

Patients focus on physical recovery. Doctors focus on preventing second stroke.

Nobody focuses on brain health.

Meanwhile: Dementia risk climbing, intervention window closing, prevention possible but not offered.

What tool enables:

Identify highest-risk patients, enroll in prevention trials, aggressive vascular management, early cognitive interventions.

Real application:

73-year-old, moderate ischemic stroke. Risk score: 45% dementia within 5 years.

Interventions: Intensive BP control (<120/80), cognitive rehabilitation, Mediterranean diet, social engagement, monthly monitoring.

3 years later: No cognitive decline, risk reduced to 15%.

Prevention worked because we predicted and intervened.

Why most don’t get this:

• Tool for research, not clinical use yet
• No reimbursement for prevention
• Not in guidelines
• Most neurologists don’t think about it

The disconnect:

• Cardiologists prevent second heart attack
• Neurologists prevent second stroke
• Nobody prevents the dementia

What stroke survivors should demand:

Baseline cognitive testing, risk stratification, prevention plan, regular monitoring.

Not “wait and see.” Act before symptoms.

What reduces risk:

Aggressive BP: 30-50% reduction

Cholesterol management: Significant

Physical activity: 35% reduction

Cognitive stimulation: Maintains reserve

Social engagement: 60% benefit

Mediterranean diet: Established

All modifiable. All underused.

Current approach: “Glad you survived the stroke.”

Better approach: “Now let’s prevent the dementia.”

Clinical trial opportunity:

Tool identifies perfect candidates, test prevention strategies, measure outcomes systematically.

Current state:

We’ve quantified risk, built prediction tool, know interventions.

Just not implementing.

Classic healthcare problem.

Know someone who’s had a stroke?
Repost if prevention should follow prediction

Follow me (Reza Hosseini Ghomi, MD, MSE) for practical neurology

Citation: Joundi RA, et al. Novel clinical risk prediction tool for dementia after transient ischemic attack and stroke. Presented at: International Stroke Conference 2026”

Title: Abstract A109: Novel clinical risk prediction tool for dementia after transient ischemic attack and stroke

Authors: Raed Joundi, Jiefeng Fang, Peter Austin, Eric Smith

Read the Full Article on Stroke/ResearchGate

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