Dementia blood biomarkers in the context of post stroke cognitive outcomes: systematic review and evidence synthesis
Author(s)
Type
Journal Article
Abstract
INTRODUCTION
The prognostic value of emerging dementia-related blood-based biomarkers for post-stroke cognitive impairment is poorly understood. We addressed this critical gap in this systematic review.
METHODS
Four databases were searched in March 2025 for studies of neurofilament light (NfL), glial fibrillary acidic protein (GFAP), amyloid beta (Aβ), tau, and placental growth factor (PlGF) in relation to post-stroke cognitive outcomes. Risk of bias, narrative synthesis, and meta-analysis were performed.
RESULTS
Eighteen studies were included, eleven assessing NfL. Meta-analysis of four studies (n = 2020) showed higher acute NfL was associated with worse cognition at 1–6 months (Z = −0.518, 95% confidence interval [CI] −0.684 to −0.351). Baseline GFAP was associated with worse cognition longitudinally, whereas results for amyloid and tau species were inconsistent between studies. Risk of bias was high.
DISCUSSION
NfL and GFAP show the most consistent associations with post-stroke cognition, particularly acutely. Evidence for amyloid and tau was inconsistent between studies, and PlGF remains unexplored.
The prognostic value of emerging dementia-related blood-based biomarkers for post-stroke cognitive impairment is poorly understood. We addressed this critical gap in this systematic review.
METHODS
Four databases were searched in March 2025 for studies of neurofilament light (NfL), glial fibrillary acidic protein (GFAP), amyloid beta (Aβ), tau, and placental growth factor (PlGF) in relation to post-stroke cognitive outcomes. Risk of bias, narrative synthesis, and meta-analysis were performed.
RESULTS
Eighteen studies were included, eleven assessing NfL. Meta-analysis of four studies (n = 2020) showed higher acute NfL was associated with worse cognition at 1–6 months (Z = −0.518, 95% confidence interval [CI] −0.684 to −0.351). Baseline GFAP was associated with worse cognition longitudinally, whereas results for amyloid and tau species were inconsistent between studies. Risk of bias was high.
DISCUSSION
NfL and GFAP show the most consistent associations with post-stroke cognition, particularly acutely. Evidence for amyloid and tau was inconsistent between studies, and PlGF remains unexplored.
Date Issued
2026-07-01
Date Acceptance
2026-06-09
Citation
Alzheimer's and Dementia, 2026, 22 (7)
ISSN
1552-5260
Publisher
Wiley
Journal / Book Title
Alzheimer's and Dementia
Volume
22
Issue
7
Copyright Statement
© 2026 The Author(s). Alzheimer’s & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer’s Association. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
License URL
Identifier
10.1002/alz.71653
Publication Status
Published
Article Number
e71653
Date Publish Online
2026-07-06