Cognitive Frailty in Older Adults with Ischemic Stroke: Epidemiology, Mechanisms, and Multidimensional Management Strategies

As global population aging accelerates, the number of older adults with ischemic stroke (IS) continues to rise. Cognitive frailty (CF), a geriatric syndrome, exhibits relatively high prevalence in this population and is associated with substantially elevated risks of disability, mortality, and poor prognosis. This review summarizes the epidemiological characteristics, underlying pathological mechanisms, and key influencing factors of CF in older patients with IS, and proposes a personalized prevention and management framework guided by digital and intelligent technologies through multidisciplinary collaboration. The aim is to provide a robust theoretical foundation and practical guidance for early identification and precise intervention targeting CF in older adults with IS. With the caveat that current evidence is constrained by regional concentration and heterogeneity in CF definitions and assessment tools, pending prospective validation through standardized protocols.