WSC 2026 | Bridging stroke and memory care to improve outcomes in cerebral small vessel disease
Joanna Wardlaw, CBE, MB ChB (Hons), MD, FRCR, FRCP, FMedSci, FRSE, The University of Edinburgh, Edinburgh, UK, comments on the need for a more holistic approach to managing patients with cognitive problems and vascular risk factors, highlighting the current separation between stroke clinics and memory clinics. Prof. Wardlaw emphasizes the importance of bringing together expertise from both fields to provide better care for patients. This interview took place at the 18th World Stroke Congress (WSC) in Seoul, Korea.
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Transcript
I think one of the issues is that generally speaking, memory clinics and places where people might go because they have a cognitive problem tend to be the memory clinics rather than a stroke clinic, and it’s reasonably fair to say that if you go to a stroke service, they will focus on things like have you had a stroke, what type was it, what are the likely causes, and you may not even get your cognitive function tested, whereas if you go to a memory clinic, they will focus on you know what is your memory, and they may go into some detail of cognitive testing, but they may not pay as much attention to the vascular risk factors...
I think one of the issues is that generally speaking, memory clinics and places where people might go because they have a cognitive problem tend to be the memory clinics rather than a stroke clinic, and it’s reasonably fair to say that if you go to a stroke service, they will focus on things like have you had a stroke, what type was it, what are the likely causes, and you may not even get your cognitive function tested, whereas if you go to a memory clinic, they will focus on you know what is your memory, and they may go into some detail of cognitive testing, but they may not pay as much attention to the vascular risk factors. So we kind of almost need a bit of a harmonization, bring the two together, use the expertise from the cognitive side and the expertise from the stroke and vascular prevention side to try and make a better package for patients. Because at the moment, it’s just, you know, if you go to a memory clinic in the UK, you’re very likely to, and if you’re thought to have mainly vascular disease, you’re more likely to be told to go and see your GP and get your blood pressure checked, whereas actually it would be not unreasonable to say look, this is somebody who really needs quite specialist thought about how to maximize the reduction in vascular risk. Anyway, we’re not there yet, but I would really like to see that people start to be more holistic in their thinking. You know, we could have – this is a criticism of stroke conferences – we could have more sessions on cognitive effects of stroke and the wider impact of cerebrovascular disease. And it’s also a criticism of dementia conferences that there’s hardly anything about vascular disease. So, you know, they’re equally too focused on some areas and not really thinking about the bigger picture. And I think individuals as clinicians also need to take a slightly more holistic view, if that’s the biggest possible gap, that stroke people need to work more closely together with memory people, and then I think we might actually get some progress.
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