TOPLINE: 

Women experienced worse functional outcomes up to 12 months after a first ischemic stroke compared to men, despite their improvements in activities of daily living (ADLs) from 3 to 6 months, a new study showed. Although both sexes showed improvement in neurologic outcomes, only men had cognitive gains within a year following the stroke.

METHODOLOGY: 

• Researchers analyzed data from the Brain Attack Surveillance in Corpus Christi Project for more than 1000 patients in Texas with first-ever ischemic stroke (mean age, 66 years; 52% men; 58% Mexican American; 34% non-Hispanic White American) between 2014 and 2019.
• Participants completed structured interviews at baseline after the onset of stroke (median time post-stroke, 7 days) and follow-up assessments at 3, 6, and 12 months, which were conducted in English or Spanish.
• Researchers analyzed functional difficulties with ADL/instrumental activities of daily living (IADL), neurologic outcomes with the National Institutes of Health Stroke Scale (NIHSS), and cognition with a modified Mini-Mental State Examination (3MSE).

TAKEAWAY:

• Women had worse functional status compared to men, as shown with higher adjusted mean ADL/ IADL scores at 3, 6, and 12 months (mean difference [MD] for all time points, 0.1).These sex differences were observed among patients with less severe stroke at baseline (initial NIHSS score of 5 or less) but not among those with moderate or severe strokes.
• Women had small but significant overall functional improvement from 3 to 12 months (adjusted MD in ADL/ IADL scores, -0.08), whereas scores for men did not change significantly.
• Neurologic outcomes improved in both sexes from 3 to 12 months, with women having a greater decrease in NIHSS scores compared to men (adjusted MDs, -0.8 vs -0.2, respectively). Only men showed cognitive improvement (adjusted MD in 3MSE scores, 0.97).

IN PRACTICE:

"Since many people live with physical, cognitive and emotional challenges after stroke, it is important to find ways to improve recovery. Our study provides a better understanding of sex differences during stroke recovery," lead author Chen Chen, PhD, University of Michigan School of Public Health, Ann Arbor, said in a press release.

SOURCE:

The study was published online December 17 in Neurology. 

LIMITATIONS: 

The study lacked data on the use of rehabilitative services. The analysis also relied on the assumption that data on outcomes were missing at random, which could have influenced the results. The study population primarily consisted of nonimmigrant Mexican American and non-Hispanic White American participants from a single community in south Texas, limiting generalizability. The assessment of cognitive outcomes was restricted to patients who could self-report.

DISCLOSURES:

The study was supported by grants from the National Institutes of Health. The investigators reported no relevant financial relationships.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.