Objective To investigate the association between dynamic trajectories of intrinsic capacity (IC) and the risk of incident stroke among Chinese adults aged 45 years and older, and to provide a novel perspective for early warning of stroke.

Methods A total of 8 321 participants with IC repeat measurement data from the 2011‒2016 waves of the China Health and Retirement Longitudinal Study (CHARLS) were included. IC was constructed by five dimension indicators: cognition, movement, vitality, sensory, and psychological. A group-based trajectory model was adopted to identify the change trajectory of IC. The primary outcome was the stroke events that occurred from 2017 to 2020. The Cox proportional hazards regression model was used to test the association between IC trajectory and stroke risk.

Results Three IC trajectories were identified, labeled as the low-stable, medium-stable, and high-stable IC trajectory groups, accounting for 41.70%, 41.63%, and 16.67% of the research population, respectively. Compared with participants in the low-stable IC trajectory group, those in the medium-stable and high-stable groups had a reduced risk of stroke, with multivariable-adjusted hazard ratios of 0.823 (95%CI: 0.689‒0.984) and 0.632 (95%CI: 0.471‒0.848), respectively.

Conclusion The longitudinal trajectories of IC are significantly negatively correlated with the incidence of stroke. IC may serve as a reliable indicator for assessing stroke risk.