Rates, Risks and Routes to Reduce Vascular Dementia

Stroke commonly affects cognition and, by definition, vascular dementia is driven by stroke disease in some way. However, fundamental knowledge about risk factors is widely acknowledged to be missing, restricting mechanistic understanding, prevention, treatment, and design of patient services.

We aim to recruit a wide range of patients with stroke, presenting to geographically diverse UK hospitals, into a longitudinal study to determine rates of, and risk factors for, cognitive and related impairments after stroke, to assess mechanisms and improve prediction models. We will recruit about 2000 patients within six weeks of stroke, collect patient, stroke, socioeconomic, lifestyle, cognitive (plus fatigue, mood) and informant data using streamlined methods appropriate to the stroke stage. We will obtain more detailed assessments at 6+/- 2weeks post baseline assessment and follow-up by phone and post yearly to at least 2 years.

We will assess diagnostic neuroimaging in all, and high-sensitivity inflammatory blood markers and genetic analysis in the majority; separate protocols will address neuroimaging and vascular function mechanism substudies.

Outputs will include reliable data on cognition long-term after stroke, stratified by prior cognition, stroke and patient-related variables, improved risk prediction and understanding the influence of neuroimaging, vascular, inflammatory and genetic markers. Participants will be in follow-up and consented for re-contact, facilitating future clinical trials.