Objective To investigate the incidence,etiology and risk factors of activity of daily life (ADL) deterioration during recovery in patients with ischemic stroke.Methods Consecutive inpatients with acute ischemic stroke from Dongguan area were enrolled prospectively.The demographic,clinical and imaging data were documented,and the patients were followed-up for 6 months.The modified Rankin Scale (mRS) 9Q was used to evaluate ADL.The mRS score 0-2 was defined as independency,and the mRS score ＞2 was defined as dependency,and the ADL deterioration was defined as transition from independency to dependency.A multivariate logistic regression model was established to analyze the factors associated with ADL deterioration.Results A total of 362 patients completed the 6-month follow-up,50 patients (13.8％) had ADL deterioration,among them,14 (3.9％) attributed to early stroke recurrence and 12 (3.3％)attributed to cognitive impairment after ischemic stroke.Multivariate logistic regression analysis showed that advanced age (odds ratio [OR] 1.099,95％ confidence interval [CI] 1.049-1.152;P ＜0.001),female (OR] 2.026,95％ CI 1.068-6.437;P =0.035),previous stroke history (OR 1.251,95％ CI 1.024-1.530;P=0.029),and higher baseline National Institutes of Health Stroke Scale (NIHSS) score (OR 1.167,95％ CI 1.016-1.284;P =0.001) were the independent risk factors for ADL deterioration.Conchtsions The ADL deterioration deterioration during recovery in patients with ischemic stroke is not uncommon.Advanced age,female,previous stroke history and higher baseline NIHSS score are the independent risk factors for ADL deterioration during recovery in patients with ischemic stroke.