The aim of this study was to observe associations between social determinants of health and risk of developing post-stroke vascular dementia (VD) 3 months post-stroke.

Stroke outcomes, especially VD, greatly impact mortality and quality of life for stroke survivors. Atrial fibrillation, hypertension, and diabetes mellitus are some risk factors to developing VD post-stroke. Socioeconomic status as a risk factor of association is also important.

We utilized TriNetX, a global health research network to compare 6 cohorts using ICD-10 and CPT codes. Cohort 1: Age 19 to 95 with ischemic or hemorrhagic stroke and poor social determinants of health. Cohort 2: Age 19 to 95 with ischemic or hemorrhagic stroke without poor social determinants of health. Cohort 3: Age 19 to 95 with poor social determinants of health, who never had a stroke. Cohort 4: Cohort 1 with stroke rehabilitation, post- stroke risk management. Cohort 5: Cohort 2 with stroke rehabilitation, post-stroke risk management. Cohorts 4 and 5 included any instance of rehabilitation within 3 months.

Comparing Cohort 1 and 2, stroke survivors with poor social determinants of health had a statistically significant higher risk of developing VD. Comparing Cohort 4 and 5, stroke survivors with poor social determinants of health had a statistically significant higher risk of developing VD, even with stroke rehabilitation, post-stroke and risk management compared to cohort of those who received rehabilitation and post-stroke management but did not have poor social determinants of health.

Our study shows a statistically significant association between social determinants of health and VD 3 months post-stroke. Patients with poor social determinants of health may not adhere to prescribed post-stroke therapies due to lack of financial means (uninsured status, lack of transportation means, limited literacy or education). Innovative interventions increasing post-stroke accessibility to treatments may help reduce VD rates and improve post-stroke outcomes.