ReviewThe journal of prevention of Alzheimer's disease2026
Pharmacological interventions for reducing the risk of cognitive decline and dementia after stroke/transient ischemic attack: A systematic review.
Review in The journal of prevention of Alzheimer's disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
5 authors.
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Abstract
backgroundStroke is a leading cause of death and disability worldwide. Advances in stroke care have improved survival and recovery, but it remains unclear whether pharmacological treatments can prevent long-term consequences including cognitive decline and dementia. This systematic review examined whether pharmacological interventions reduce the risk of cognitive decline, mild cognitive impairment (MCI), or dementia in adults with a history of stroke or symptomatic transient ischemic attack (TIA).
methodsWe searched Medline, EMBASE, PsychINFO, and Cochrane Central from inception to January 23, 2025, for systematic reviews and meta-analyses of randomized controlled trials (RCTs). Eligible studies included adults with prior stroke or symptomatic TIA receiving pharmacological interventions, blood pressure-lowering, antithrombotic, and lipid-lowering drugs, compared with placebo, no treatment, or usual care. Primary outcomes were incident dementia, MCI, and cognitive decline assessed at least three months post-event. Methodological quality was assessed with AMSTAR 2, and certainty of evidence using GRADE. The protocol was registered in PROSPERO (CRD420251000825).
resultsOf 1343 records screened, 8 systematic reviews met inclusion criteria. The most comprehensive systematic review, including all relevant RCTs, was selected for detailed data extraction. Certainty of evidence was mostly low, with a few exceptions of moderate to high certainty. Across drug classes and outcomes, pharmacological interventions generally showed no meaningful reductions in dementia, MCI, and cognitive decline over a mean follow-up of 2.0-4.9 years.
conclusionsCurrent evidence does not support pharmacological interventions after a cerebrovascular event for reducing risk of cognitive decline, MCI, or dementia. Further high-quality studies with longer follow-ups are needed.
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