China has entered a comprehensive aging society, and stroke is the primary cause of death and disability among adults in China, post-stroke cognitive impairment has become an important cause for long-term disability and quality of life decline in stroke patients.

To analyse and clarify the prevalence and influencing factors of cognitive impairment in elderly stroke patients in China by Meta-analysis.

CNKI, Wanfang Data, VIP, China Biology Medicine disc (CBM), PubMed, Embase, Cochrane Library, and Web of Science were searched by computer to collect cohort, case-control, and cross-sectional studies on influencing factors of cognitive impairment in elderly stroke patients from inception to 2023-02-12. After independent screening of the literature and data extraction by two investigators, the quality of the literature was assessed and a Meta-analysis of the prevalence and influencing factors of cognitive impairment in elderly stroke patients in China was performed using Stata 14.0 software.

A total of 46 papers were included, with 3 281 cases of cognitive impairment and 27 influencing factors involved. The Meta-analysis results showed that the prevalence of cognitive impairment in elderly stroke patients in China was 42.4%〔95%CI (36.6%, 48.3%) 〕; female〔OR=4.167, 95%CI (1.937, 8.967), P<0.001〕, hypertension〔OR=2.824, 95%CI (2.292, 3.481), P<0.001〕, systolic blood pressure〔OR=1.572, 95%CI (1.444, 1.711), P<0.001〕, diabetes mellitus〔OR=3.344, 95%CI (2.611, 4.284), P<0.001〕, hyperlipidemia 〔OR=2.228, 95%CI (1.091, 4.547), P=0.028〕, carotid plaque 〔OR=2.544, 95%CI (1.076, 6.014), P=0.033〕, infarction location of frontal lobe〔OR=1.615, 95%CI (1.167, 2.235), P=0.004〕, infarction location of temporal lobe〔OR=1.739, 95%CI (1.246, 2.427), P=0.001〕, multiple cerebral infarction〔OR=2.583, 95%CI (2.009, 3.321), P<0.001〕, encephalanalosis 〔OR=2.943, 95%CI (1.938, 4.469), P<0.001〕, homocysteine (Hcy) 〔OR=2.209, 95%CI (1.656, 2.948), P<0.001〕, hyperhomocysteinemia〔OR=3.043, 95%CI (2.092, 4.426), P<0.001〕, high-sensitivity C-reactive protein (hs-CRP) 〔OR=4.331, 95%CI (1.756, 10.685), P=0.001〕, and National Institutes of Health Stroke Scale (NIHSS) score >10〔OR=1.977, 95%CI (1.320, 2.961), P=0.001〕 were influencing factors for cognitive impairment in elderly stroke patients in China.

The prevalence of cognitive impairment in elderly stroke patients in China was high (42.4%), and female, hypertension, systolic blood pressure, diabetes mellitus, hyperlipidemia, carotid plaque, infarction location of frontal lobe and temporal lobe, multiple cerebral infarction, encephalanalosis, Hcy, hyperhomocysteinemia, hs-CRP, and NIHSS score >10 were influencing factors for cognitive impairment in elderly stroke patients in China.

我国已进入全面老龄化社会，脑卒中是我国成人致死、致残的首位病因，脑卒中后认知障碍成为脑卒中患者长期残疾和生活质量下降的重要原因。

通过Meta分析明确中国老年脑卒中患者认知障碍的患病率和影响因素。

计算机检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库（CBM）、PubMed、Embase、Cochrane Library、Web of Science，收集建库至2023-02-12发表的有关老年脑卒中患者认知障碍的影响因素的队列研究、病例对照研究和横断面研究。由2名研究者独立筛选文献、提取数据后，对纳入研究进行文献质量评估，采用Stata14.0软件对我国老年脑卒中患者认知障碍患病率和影响因素进行Meta分析。

共纳入46篇文献，认知障碍患者3 281例，涉及影响因素27项。Meta分析结果显示：我国老年脑卒中患者认知障碍患病率为42.4%〔95%CI（36.6%，48.3%）〕。女性〔OR=4.167，95%CI（1.937，8.967），P<0.001〕、高血压〔OR=2.824，95%CI（2.292，3.481），P<0.001〕、收缩压〔OR=1.572，95%CI（1.444，1.711），P<0.001〕、糖尿病〔OR=3.344，95%CI（2.611，4.284），P<0.001〕、高脂血症〔OR=2.228，95%CI（1.091，4.547），P=0.028〕、颈动脉斑块〔OR=2.544，95%CI（1.076，6.014），P=0.033〕、梗死灶位置（额叶、颞叶）〔额叶：OR=1.615，95%CI（1.167，2.235），P=0.004；颞叶：OR=1.739，95%CI（1.246，2.427），P=0.001〕、多发性脑梗死〔OR=2.583，95%CI（2.009，3.321），P<0.001〕、脑萎缩〔OR=2.943，95%CI（1.938，4.469），P<0.001〕、同型半胱氨酸（Hcy）〔OR=2.209，95%CI（1.656，2.948），P<0.001〕、高同型半胱氨酸血症〔OR=3.043，95%CI（2.092，4.426），P<0.001〕、超敏C反应蛋白（hs-CRP）〔OR=4.331，95%CI（1.756，10.685），P=0.001〕、美国国立卫生研究院脑卒中评定量表（NIHSS）评分>10分〔OR=1.977，95%CI（1.320，2.961），P=0.001〕为我国老年脑卒中患者认知障碍的影响因素。

我国老年脑卒中患者认知障碍患病率较高（42.4%），且女性、高血压、收缩压、糖尿病、高脂血症、颈动脉斑块、梗死灶位置（额叶、颞叶）、多发性脑梗死、脑萎缩、Hcy、高同型半胱氨酸血症、hs-CRP、NIHSS评分为我国老年脑卒中患者认知障碍的影响因素。