Post-stroke cognitive impairment (PSCI) is a common sequela of stroke that severely impacts patients' quality of life and is often overlooked. The high incidence, subtle symptoms, and substantial social burden of PSCI make it a research priority. Understanding the prevalence and associated factors of PSCI is crucial for improving stroke prevention and treatment strategies.

To systematically evaluate the prevalence and trends of PSCI in China from 2014 to 2024 and summarize the related risk and protective factors.

Relevant studies on the prevalence and influencing factors of PSCI in China were retrieved from databases including PubMed, Web of Science, Embase, CNKI, Wanfang Data, VIP and CBM covering the period from January 2014 to November 2024. Stata 16.0 and SPSS 26.0 software were used to analyze the current status and trends of PSCI, and RevMan 5.4 software was employed to analyze related factor.

A total of 59 studies were included in this analysis, revealing that the overall prevalence of PSCI in China was 51% (95%CI=48%-55%). The prevalence of PSCI among males and females was 50% (95%CI=46%-54%) and 56% (95%CI=51%-60%), respectively. Patients aged under 60 years and those aged 60 years and above exhibited prevalence rates of 47% (95%CI=40%-55%) and 59% (95%CI=50%-67%), respectively. The prevalence in East China, South China, North China, Central China, Northeast China, Northwest China and Southwest China was 49% (95%CI=42%-56%), 48% (95%CI=36%-61%), 53% (95%CI=44%-62%), 48% (95%CI=40%-56%), 57% (95%CI=54%-60%), 42% (95%CI=32%-52%) and 51% (95%CI=43%-59%), respectively. Furthermore, the prevalence of hemorrhagic and ischemic stroke was 54% (95%CI=41%-67%) and 52% (95%CI=48%-56%), respectively. At different time points (≤2 weeks, >2 weeks~3 months, >3~6 months, >6 months), the prevalence rates were 52% (95%CI=45%-58%), 52% (95%CI=45%-58%), 40% (95%CI=35%-44%) and 56% (95%CI=43%-70%) respectively. The highest prevalence rate of 63% (95%CI=55%-71%) was observed in individuals with lower education levels (primary school and below). Additionally, the prevalence among married and unmarried individuals was 57% (95%CI=46%-68%) and 64% (95%CI=52%-75%), respectively. The prevalence among employed and unemployed individuals was 64% (95%CI=44%-84%) and 71% (95%CI=56%-87%), respectively. Finally, the prevalence among mental workers and manual workers was 48% (95%CI=33%-64%) and 53% (95%CI=30%-76%), respectively, while those living with family members and living alone exhibited prevalence rates of 62% (95%CI=43%-82%) and 71% (95%CI=62%-81%), respectively. The prevalence of PSCI in China increased with age (χ²=73.805, P<0.01), and was notably higher among individuals with lower education levels (χ²_trend=164.711, P<0.01). There were significant differences among different regions (χ²=74.701, P<0.01). With the extension of assessment periods, the prevalence showed an upward trend (χ²_trend=186.504, P<0.05). Although a significant difference in prevalence rates was observed across different periods (χ²_trend=325.964, P<0.01), no linear correlation was identified (P=0.259). Factors such as age, female gender, hypertension, diabetes, hyperlipidemia, a history of stroke, carotid plaque, hyperhomocysteinemia, C-reactive protein levels, smoking, drinking and NIHSS score were identified as risk factors for PSCI in China, whereas education level and physical exercise emerged as protective factors.

The overall prevalence of PSCI in China is notably high, exhibiting significant regional and provincial variations, as well as a dynamic trend over time. The prevalence is particularly elevated among females, the elderly, and individuals with lower educational attainment. Additionally, hypertension, diabetes, and hyperlipidemia are identified as risk factors for PSCI. It is imperative for medical institutions at all levels to prioritize these high-risk groups, and expedite the development and implementation of comprehensive prevention and control strategies for PSCI to alleviate the social care burden and economic strain in China.

脑卒中后认知障碍（PSCI）是脑卒中患者常见的后遗症，严重影响了患者的生活质量，且易被忽视。PSCI的高发病率、隐匿性症状和沉重的社会负担使其成为研究重点。了解PSCI的患病情况和相关因素，对于制订脑卒中的防治策略至关重要。

系统评价2014—2024年我国PSCI患病现状及发展趋势，总结归纳PSCI相关危险因素和保护因素。

系统检索PubMed、Web of Science、Embase、中国知网（CNKI）、万方数据知识服务平台（Wanfang Data）、维普网（VIP）和中国生物医学文献数据库（CBM），搜集关于中国PSCI患病率及危险因素的研究，检索时限为2014年1月—2024年11月。利用Stata 16.0和SPSS 26.0软件分析PSCI的现状与趋势，并使用RevMan 5.4软件分析相关因素。

共纳入59项研究，Meta分析结果显示，我国PSCI总体患病率为51%（95%CI=48%~55%）。男性和女性的PSCI患病率分别为50%（95%CI=46%~54%）和56%（95%CI=51%~60%）；<60岁和≥60岁患者患病率分别为47%（95%CI=40%~55%）和59%（95%CI=50%~67%）；华东、华南、华北、华中、东北、西北及西南地区的患病率依次为49%（95%CI=42%~56%）、48%（95%CI=36%~61%）、53%（95%CI=44%~62%）、48%（95%CI=40%~56%）、57%（95%CI=54%~60%）、42%（95%CI=32%~52%）和51%（95%CI=43%~59%）；出血性和缺血性卒中的患病率分别为54%（95%CI=41%~67%）和52%（95%CI=48%~56%）；不同评估时间点（≤2周、>2周~3个月、>3~6个月、>6个月）的患病率分别为52%（95%CI=45%~58%）、52%（95%CI=45%~58%）、40%（95%CI=35%~44%）和56%（95%CI=43%~70%）；小学及以下者患病率为63%（95%CI=55%~71%）；已婚、未婚者分别为57%（95%CI=46%~68%）、64%（95%CI=52%~75%）；有工作者、无业者分别为64%（95%CI=44%~84%）、71%（95%CI=56%~87%）；脑力劳动、体力劳动者分别为48%（95%CI=33%~64%）、53%（95%CI=30%~76%）；与家人同住、独居者分别为62%（95%CI=43%~82%）和71%（95%CI=62%~81%）。我国PSCI的患病率随着年龄增加而增高（χ²=73.805，P<0.01）；文化程度较高者PSCI患病率较低（χ²_趋势=164.711，P<0.01）；不同地区PSCI患病率比较，差异有统计学意义（χ²=74.701，P<0.01）。随着评估时间延长，患病率呈上升趋势（χ²_趋势=186.504，P<0.05）；各时段之间PSCI患病率比较，差异有统计学意义（χ²_趋势=325.964，P<0.01），但未表现出线性相关性（P=0.259）。高龄、女性、高血压、糖尿病、高脂血症、卒中史、颈动脉斑块、高同型半胱氨酸血症、C反应蛋白水平升高、吸烟、饮酒和高美国国立卫生研究院卒中量表（NIHSS）评分是我国脑卒中患者发生PSCI的危险因素，而受教育水平高和体育锻炼是其保护因素（P<0.05）。

我国PSCI总体患病率较高（51%），不同地区、省份之间存在明显差异，且随着时间发展呈现出动态变化趋势。女性、高龄、受教育程度低等群体PSCI患病率较高。此外，高血压、糖尿病、高脂血症等是PSCI发病的危险因素，各级医疗机构应重点关注以上高危人群，加快制订并实施PSCI综合防治策略，以减轻我国社会照护压力和经济负担。