Patient-voice themes

1. Cognitive problems after stroke are under-recognized

Patients and carers describe memory problems that affect daily life and barriers to identifying or seeking help. Cognitive testing can be acceptable when its purpose and consequences are clear (Tang 2019, PMID 30452613; Tang 2020, PMID 32637417; McMahon 2024, PMID 38226361).

2. Diagnosis and labels create uncertainty

VCI may be described as post-stroke impairment, vascular dementia, or mixed dementia. General dementia qualitative syntheses show that explanatory models and stigma shape help-seeking; this likely intensifies when labels change, but vascular-specific prevalence is unknown (Nguyen 2023, PMID 35549573; Johnston 2020, PMID 31074290).

3. Caregiving is sustained coordination and adaptation

Spousal and minority-ethnic caregiver syntheses describe role change, vigilance, practical coordination, and culturally specific expectations. These are dementia-wide findings, not vascular-only estimates (Macdonald 2020, PMID 32813338; Lillekroken 2023, PMID 34786789).

4. Daily function outranks small score changes

Post-stroke memory studies emphasize everyday effects, while treatment trials show cognitive-scale improvements without consistent ADL gains. Together they support measuring medication management, communication, participation, and caregiver workload (Tang 2020, PMID 32637417; Battle 2021, PMID 33704781).

5. Joined-up stroke and dementia care is a priority

Post-stroke help-seeking barriers and guideline calls for longitudinal VCI management point to a service gap between acute stroke, rehabilitation, primary care, and memory services (Tang 2019, PMID 30452613; Swartz 2025, PMID 39822128).

Coverage caveat

Qualitative themes show recurring experiences, not their frequency. Severe aphasia, institutional care, low-resource settings, and non-English sources remain underrepresented.