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Health & Medicine for Senior Citizens

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.


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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 Southwestern.

Support for the study was provided by the National Institute of Neurological Disorders and Stroke KO2 NS058760.


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