Abstract
Background: Cardiovascular multimorbidity is highly prevalent in ageing populations and is a key determinant of stroke risk and long-term disability. However, data on recurrent ischemic stroke and related functional outcomes in Central Asia remain limited. Aim: To evaluate cardiovascular multimorbidity and its association with recurrent ischemic stroke, cognitive impairment, and functional status in older adults in Southern Kazakhstan. Methods: A cross-sectional study included 2,481 individuals aged ≥60 years. In addition, clinical data from 84 patients with ischemic stroke, including 44 with recurrent events, were analyzed. Sociodemographic characteristics, chronic disease profiles, vascular risk factors, cognitive status, and functional dependence were assessed. Statistical analysis included descriptive statistics, χ² test, independent t-test, and logistic regression analysis. Results: Multimorbidity was highly prevalent and more frequent in women. Among patients with recurrent ischemic stroke, the most common comorbidities and risk factors were arterial hypertension (83.5%), chronic heart failure (97.7%), generalized atherosclerosis (50.0%), diabetes mellitus (31.8%), obesity (29.5%), and smoking (34.1%). Recurrent stroke was associated with a higher burden of cardiovascular multimorbidity and older age. Cognitive impairment was identified in 68.2% of patients with recurrent stroke, including dementia in 18.2%. Functional dependence was observed in 72.7% of cases. Conclusions: Cardiovascular multimorbidity is strongly associated with recurrent ischemic stroke in older adults. Recurrent stroke is linked to higher rates of cognitive impairment and functional dependence. These findings underscore the need for integrated prevention and management strategies targeting cardiovascular risk factors in ageing populations.