Abstract: Objective To analyze the burden of stroke attributable to dietary factors in the elderly population（age≥60） in China from 1990 to 2021 and the trends over time,providing a reference for stroke prevention and control. Methods Data on the burden of stroke attributable to dietary factors in the elderly population（≥ 60 years old） were extracted from the Global Burden of Disease （GBD） 2021 database. The disease burden was described using the number of deaths,age-standardized mortality rate（ASMR）,disability-adjusted life years（DALYs）,age-standardized DALY rate,and population attributable fraction（PAF）. The trend of change in the disease burden attributable to dietary factors was analyzed using the percentage change and estimated annual percentage change（EAPC）. A Bayesian Age-Period-Cohort（BAPC） model was used to predict the trend from 2022 to 2035. Results From 1990 to 2021,the number of deaths and DALYs attributable to dietary factors in the elderly population of China showed an overall increasing trend,but both the ASMR and age-standardized DALY rate showed a decreasing trend. The ASMR decreased from 311.49 per 100 000 in 1990 to 149.45 per 100 000 in 2021,with a change rate of -52.02% and an EAPC of -2.50%（P<0.01）. The age-standardized DALY rate decreased from 5 821.82 per 100 000 in 1990 to 2 824.21 per 100 000 in 2021,with a change rate of -51.49% and an EAPC of -2.47%（P<0.01）. Gender analysis revealed that male ASMR（EAPC：-2.02%,P< 0.01） and age-standardized DALY rate（EAPC：-2.05%,P<0.01） were higher than females,while the decline in ASMR（EAPC：-3.26%,P<0.01） and age-standardized DALY rate（EAPC：-3.17%,P<0.01） was more significant in females. Age group analysis showed an increasing trend in the burden of stroke attributable to dietary factors with age from 1990 to 2021. The ASMR and age-standardized DALY rate in the 90-94 age group were the highest,with change rates of -43.55% and -42.26%,respectively,and EAPC values of -1.94%（P<0.01） and -1.87%（P<0.01） in 2021 compared to 1990. The 60-64 age group had the most significant decrease in ASMR and age-standardized DALY rate,with a decrease of 60.13% and 57.11%,respectively,and EAPC values of -3.06%（P<0.01） and -2.82%（P<0.01）. PAF analysis of dietary factors showed that excessive sodium intake and insufficient fruit intake remained the top two factors contributing to stroke,while the consumption of processed red meat and sugary drinks showed an increasing trend. Based on the BAPC model,the ASMR attributable to dietary factors in the elderly population of China was expected to decrease to 97.29 per 100 000,and the age-standardized DALY rate was expected to decrease to 1 883.17 per 100 000 by 2035. Conclusion From 1990 to 2021,the burden of stroke attributable to dietary factors among the elderly population in China has decreased,but the overall disease burden remains significant. Excessive sodium intake and insufficient fruit consumption have consistently been the primary risk factors,while the consumption trends of processed red meat and sugar-sweetened beverages warrants attention. Future prevention and control strategies should focus on interventions for high-risk dietary factors,particularly among men and high-risk groups,to further reduce the stroke burden.

Key words: Elderly population, Stroke, Dietary factors, Disease burden, Prediction