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Sex differences in stroke recovery.

Sue-Min Lai1, Pamela W Duncan, Paul Dew

  • 1Department of Preventive Medicine and Public Health, The University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160-7313, USA. slai@kumc.edu

Preventing Chronic Disease
|June 21, 2005
PubMed
Summary

Women experience poorer stroke recovery than men, particularly in instrumental activities of daily living. Factors like older age, lower prestroke physical functioning, and depression contribute to these sex differences in stroke outcomes.

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Area of Science:

  • Neuroscience
  • Rehabilitation Medicine
  • Gerontology

Background:

  • Stroke recovery varies significantly between sexes, impacting daily functioning.
  • Understanding sex-based disparities in post-stroke recovery is crucial for targeted interventions.

Purpose of the Study:

  • To investigate sex differences in basic activities of daily living (ADL), instrumental activities of daily living (IADL), and physical functioning post-stroke.
  • To determine if depressive status explains observed sex differences in stroke recovery, beyond age, stroke severity, and comorbidities.

Main Methods:

  • Prospective study of 459 stroke patients followed for 6 months.
  • Standardized assessments included NIH Stroke Scale, Barthel ADL Index, Lawton IADL scale, SF-36 physical functioning, and Geriatric Depression Scale.

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  • Outcomes measured at baseline, 1, 3, and 6 months post-stroke; prestroke functioning and comorbidities also assessed.

    • Main Results:

    • Women were older and had lower prestroke physical functioning than men.
    • Six months post-stroke, women were less likely to achieve independence in IADL (HR=0.46) compared to men, even after controlling for covariates (HR=0.51).
    • No significant sex differences were found in achieving independence in basic ADL or higher physical functioning.

    Conclusions:

    • Prestroke physical functioning and depressive symptoms are key factors in sex differences in stroke recovery.
    • Poorer recovery of IADL and physical functioning in women may be multifactorial, including older age, lower prestroke function, and depression.