Association of multimorbidity with biological age acceleration in acute ischemic stroke patients: a cross-sectional study

Abstract Background Multimorbidity may influence biological aging, particularly in acute ischemic stroke (AIS) patients with high comorbidity burden. However, evidence on associations between multimorbidity and biological aging in AIS remains limited, with unclear differential impacts of specific multimorbidity clusters. This study evaluated latent multimorbidity patterns in AIS patients and quantified relationships between multimorbidity and biological age (BA) acceleration. Methods This study included AIS patients from Ischemic Cerebrovascular Disease Database of the First Affiliated Hospital of Zhengzhou University between 2018 and 2019. BA was assessed using the Klemera-Doubal method biological age (KDM-BA) and Phenotypic Age (PhenoAge). Latent class analysis (LCA) identified multimorbidity clusters. Generalized linear model evaluated associations between multimorbidity and BA acceleration. Results A total of 2539 AIS patients were included, with 90% exhibiting multimorbidity (≥2 comorbidities). Each additional chronic condition was associated with a 3.78-year increase in KDM-based age acceleration (95%CI: 3.00-4.55, fully adjusted) and 0.78-year increase in phenotypic age acceleration (95%CI: 0.56-1.00, fully adjusted). Among multimorbidity patterns, the hyperglycemia-hypertension pattern showed the strongest association with KDM-AA (β = 11.59, 95%CI : 9.61-13.58), followed by cardiac dysfunction (β = 7.89, 95%CI : 3.11-12.66). Conclusion The overwhelming majority of AIS patients exhibit multimorbidity, which is associated with accelerated biological aging. Metabolic-vascular multimorbidity show the strongest links to this association. Prospective studies are needed to further explore the causal relationship between multimorbidity and biological aging acceleration.