Multidimensional Analysis of Frailty and Its Influencing Factors in Hospitalized Elderly Stroke Patients

Background: Frailty is a common geriatric syndrome, and its occurrence in elderly stroke patients may further worsen clinical outcomes, yet the influencing factors and potential causal relationship remain unclear. Objective: This study aimed to identify the influencing factors of frailty in elderly hospitalized stroke patients and to analyze the potential causal relationship between stroke and frailty. Methods: A multicenter cross-sectional survey including 210 elderly stroke patients was conducted, and bidirectional Mendelian randomization analysis was applied to examine the causal relationship between stroke and frailty. Univariate and multivariate logistic regression analyses were used to explore the impact of physiological, psychological, and clinical symptom factors on frailty. Results: The frailty index was positively correlated with stroke, and Mendelian randomization confirmed a bidirectional causal relationship. Univariate analysis showed significant associations between frailty and diabetes, lesion site, lesion location, and brain atrophy. Multivariate logistic regression further identified Fugl-Meyer score, Berg score, and MoCA score as independent risk factors for frailty in elderly hospitalized stroke patients. Conclusion: Frailty is strongly associated with stroke, and elderly stroke patients face an increased risk of frailty during hospitalization. These findings provide a basis for early identification of high-risk patients and the development of targeted intervention strategies in clinical practice, with important implications for stroke rehabilitation and elderly care.