| Summary: | Abstract Background Stroke is still remarked as one of the major ailments in Indonesia. Cognitive impairment occurs frequently after stroke events and its predictors are needed to identify patients with a high risk of cognitive impairment. However, the researches done in Indonesia still vary in results. This retrospective cohort study evaluated 236 ischemic stroke patients in Bethesda Hospital Yogyakarta from January–November 2020 through medical records. Cognitive impairment was measured by MMSE and CDT, defined as MMSE score $$\le$$ ≤ 20 for patients with the educational attainment of 1–6 years; $$\le$$ ≤ 24 for the educational attainment of > 6 years and/ or CDT < 4. All data were analyzed with univariate test and Chi-square test, followed by logistic regression. Results Of 236 subjects, the frequency of cognitive impairment was 67.4% and the risk factors are age > 80 years old (RR: 1,545; CI 0.136–17.542; p: 0.026), educational attainment ≤ 6 years (RR: 20.016; CI 1.951–222.120; p: 0.012), temporal (RR: 4.238; CI 2.266–7.926; p: 0.007) or multiple site lesion location (RR: 7.522; CI: 3.522–17.532; p: 0.047) and multiple (> 1) lesions (RR: 1,819; CI 0.822–4.022; p: 0.040). Conclusions The prevalence of post-stroke cognitive impairment is high, affecting up to 2 out of 3 people in this study. The risk factors of post-stroke cognitive impairment are age > 80 years, educational attainment $$\le$$ ≤ 6 years, temporal or multiple site lesion, and > 1 lesion. Strict stroke prevention strategies are needed to halt the development of post-stroke cognitive impairment.
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