Women Fare Worse Following Stroke;
Difference Greatest in Those Over Age 75
Follow-up study to look at cognitive decline in men
and women before and after stroke
Feb. 7, 2014 The good news about stroke is that
more people survive stroke now than 10 years ago due to improved
treatment and prevention. The bad news: women who survive stroke have a
worse quality of life than men and the difference is greatest for the
elderly, according to a study published just one day after the American
heart and stroke associations issued the
first guidelines aimed
specifically at preventing strokes in women.
Researchers at Wake Forest Baptist Medical Center
compared the quality of life in men and women who had a stroke or
transient ischemic attack (TIA). Their results are reported in the Feb.
7 online issue of the journal Neurology.
A total of 1,370 patients ages 56 to 77 from the
AVAIL registry a national, multicenter, longitudinal registry of
ischemic stroke and TIA patients were included in the study.
The patients quality of life was measured at three
months and one year after a stroke or TIA using a formula that assesses
mobility, self-care, everyday activities, depression/anxiety and pain.
We found that women had a worse quality of life
than men up to 12 months following a stroke, even after considering
differences in important socio-demographic variables, stroke severity
and disability, said Cheryl Bushnell, M.D., associate professor of
neurology at Wake Forest Baptist and senior author of the study.
As more people survive strokes, physicians and
other healthcare providers should pay attention to quality of life
issues and work to develop better interventions, even gender-specific
screening tools, to improve these patients lives.
The study findings showed that at three months,
women were more likely than men to report problems with mobility,
pain/discomfort and anxiety and depression, but the difference was
greatest in those over age 75. At one year, women still had lower
quality of life scores overall than men but the magnitude of those
differences had diminished, Bushnell said.
The reason we do these types of studies is to be
able to add different variables sequentially to determine what accounts
for these gender differences, Bushnell said. We found that age, race
and marital status accounted for the biggest differences between men and
women at three months, with marital status being the most important.
Even though the women in the study were older than the men, our study
showed that age really had very little effect on quality of life.
The results suggest that further research on
mobility, pain or discomfort and anxiety/depression may provide a
clearer understanding for how to improve the lives of women after
stroke, Bushnell added.
The next step for the Wake Forest Baptist team will
be to look at the trajectory of cognitive decline in men and women
before and after stroke, she said.
Co-authors of the study are Mathew J. Reeves,
Ph.D., Michigan State University; Xin Zhao, M.S., Wenqin Pan, Ph.D.,
Louise Zimmer, M.A., M.P.H., Eric Peterson, M.D., M.P.H., of Duke
Clinical Research Institute; Janet Prvu-Bettger, Sc.D., Duke University
School of Nursing; and DaiWai Olson, Ph.D., R.N., University of Texas
Support for the study was provided by the National
Institute of Neurological Disorders and Stroke KO2 NS058760.
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