Key PointsQuestionAre higher blood pressure, glucose, and low-density lipoprotein cholesterol in stroke survivors associated with cognitive decline?FindingsIn this cohort study using a meta-analysis of individual participant data from 982 stroke survivors from 4 cohort studies, higher cumulative mean poststroke glucose level, but not blood pressure or low-density lipoprotein cholesterol levels, was associated with faster decline in global cognition.MeaningThese findings suggest that higher cumulative glucose levels may contribute to faster cognitive decline in stroke survivors, representing a potential treatment target to preserve cognition after stroke.