Abstract: The global aging trend poses significant public health challenges, with elderly stroke being particularly severe. The unique characteristics of elderly patients, such as frailty, multimorbidity, and polypharmacy, lead to extreme complexity in risk-benefit assessment and a gap between clinical guidelines and practice. This paper systematically reviews evidence-based management for elderly stroke and proposes a data-driven integrated “prevention, treatment, management, and rehabilitation” paradigm empowered by AI and digital technology. Optimized for elderly vulnerability, the paradigm explores precision risk control in “prevention”, reperfusion therapy and the “tissue window” concept in “treatment”, stroke unit-based continuous quality improvement in “management”, and the transformative role of telemedicine and wearables in “rehabilitation”. Finally, implementation barriers and equity challenges are analyzed. Building an integrated system that combines clinical evidence with cutting-edge digital technology is the core path to improving outcomes for elderly stroke patients.

Key words: aged, stroke, artificial intelligence, continuity of care, integrated strategy