Inconsistent definitions and outcome measurement: A systematic review of impairments following transient ischaemic attack and minor stroke

Objective This systematic review aimed to synthesise and characterise studies reporting cognitive, psychological and participation outcomes in transient ischaemic attack (TIA) and minor stroke, including how impairments are measured, definitions of TIA and minor stroke and study representativeness. Methods Systematic searches of PubMed, Embase, CINAHL, PsycInfo and the Cochrane Library were conducted (from 2013 to 4 June 2026). Articles included participants with TIA/minor stroke and quantitative measures of fatigue, cognitive or communication impairments, depression, anxiety, quality of life, return to work/education or social participation. Results Searches identified 39,136 records, with 190 articles included (comprising 64,638 participants). Cognitive impairment was most frequently reported ( n = 134), followed by depression ( n = 71) and quality of life ( n = 46). Less common were fatigue ( n = 33), social participation ( n = 16), return to work/education ( n = 14) and communication impairment ( n = 8). Only 41 studies (21.6%) examined these impairments as primary outcomes. There was heterogeneity in the definition of TIA/minor stroke, the outcome measures and cut-off scores, as well as under-representation from lower-middle and low-income countries and female participants. Ethnicity was rarely reported. Discussion We identified a large volume of literature that measured lasting impairment following TIA/minor stroke; however, these were seldom the primary outcome. Substantial heterogeneity in outcome measures, cut-off scores and TIA/minor stroke definitions limited comparability across studies. Conclusion This review highlights the need for a core outcome set in TIA/minor stroke assessments. Clinicians should recognise that cognitive, psychological and participation difficulties may persist after TIA/minor stroke and ensure these outcomes are considered from initial to follow-up assessments.