Female Survivors Fare Worse After Stroke

A new study finds female stroke survivors experience less quality of life than men who have suffered a stroke.

In a study of 1,370 patients ages 56 to 77 from the AVAIL registry— a national, multicenter, longitudinal registry of ischemic stroke and transient ischemic attack (TIA) patients—researchers at Wake Forest Baptist Medical Center compared the quality of life in men and women who had a stroke or transient ischemic attack.

Investigators measured patients’ quality of life at 3 months and 1 year after a stroke or TIA, using a formula that assesses mobility, self-care, everyday activities, depression, anxiety, and pain. The group found that women had a worse quality of life than men up to 12 months following a stroke, even taking into consideration the differences in important socio-demographic variables, stroke severity, and disability, according to the authors.

According to the study, women at 3 months post-stroke were more likely than men to report problems with mobility, pain and discomfort, and anxiety and depression, but the difference was greatest in those over age 75. At 1 year, women still had lower quality of life scores overall, but the magnitude of those differences had diminished.

In addition, the researchers found that age, race, and marital status accounted for the biggest differences between men and women at 3 months, with marital status being the most important. Even though the women in the study were older than the men, the study showed that age had very little effect on quality of life. The Wake Forest team will next look at the trajectory of cognitive decline in men and women before and after stroke, according to study authors, who note that these results suggest further research onmobility, pain and discomfort, and anxiety and depression may provide a clearer understanding of how to improve the lives of women after stroke.

With regard to treating female patients who have experienced a stroke, “primary care practitioners could be screening for issues related to pain—including headaches, joint pain, and frozen joints—as a result of the stroke,” says Cheryl Bushnell, MD, associate professor of neurology at Wake Forest Baptist Medical Center, and senior author of the study. Screening this group for depression and anxiety, as well as mobility problems, may also be advised, adds Bushnell.

“These are probably things these providers do anyway, but having them as a checklist for women post-stroke, and men for that matter, would be great ways to screen for the problems we think diminish quality of life after stroke,” she says. “Any complicated issues related to the stroke could prompt a referral to a stroke neurologist or rehab expert.”

Reference

Bushnell C, Reeves M, et al. Sex differences in quality of life after ischemic stroke. Neurology. 2014.