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<p>This study evaluated the factors predisposing women to a more substantial functional decline than men in the chronic phase of stroke. Sex differences in functional worsening and improvement, defined as an increase and decrease in one or more modified Rankin Scale scores between the 3-month and each assessment point throughout 5 years after ischemic stroke were examined using data from a multicenter prospective stroke registry in Japan. Logistic regression analysis was performed to estimate the risk of unfavorable outcomes in women after adjusting for potential confounders. The interactions between sex and confounders were also assessed. Among 6848 patients who survived for 5 years poststroke, 39.3% were female. Female survivors were more likely to experience unfavorable functional outcomes throughout 5 years post-stroke than male survivors. The higher risk of functional worsening in women than men was more apparent among patients aged &gt;&#xa0;75&#xa0;years and those without limb weakness (<i>P</i> for interaction for age 0.04 and for limb weakness 0.03). Older female patients, frequently experiencing frailty and multimorbidity, should be targeted in poststroke interventions to reduce the burden of long-term disability after stroke. Female patients without apparent motor impairment might also benefit from physical activity programs to maintain muscle strength.</p>

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Factors related to sex differences in long-term functional decline after acute ischemic stroke

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月18日

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  • Fumi Irie,
  • Kuniyuki Nakamura,
  • Ryu Matsuo,
  • Yoshinobu Wakisaka,
  • Tetsuro Ago,
  • Takanari Kitazono,
  • Masahiro Kamouchi,
  • Takao Ishitsuka,
  • Setsuro Ibayashi,
  • Kenji Kusuda,
  • Kenichiro Fujii,
  • Tetsuhiko Nagao,
  • Yasushi Okada,
  • Masahiro Yasaka,
  • Hiroaki Ooboshi,
  • Katsumi Irie,
  • Tsuyoshi Omae,
  • Kazunori Toyoda,
  • Hiroshi Nakane,
  • Hiroshi Sugimori,
  • Shuji Arakawa,
  • Kenji Fukuda,
  • Jiro Kitayama,
  • Shigeru Fujimoto,
  • Shoji Arihiro,
  • Junya Kuroda,
  • Yoshihisa Fukushima,
  • Takuya Kiyohara

摘要

This study evaluated the factors predisposing women to a more substantial functional decline than men in the chronic phase of stroke. Sex differences in functional worsening and improvement, defined as an increase and decrease in one or more modified Rankin Scale scores between the 3-month and each assessment point throughout 5 years after ischemic stroke were examined using data from a multicenter prospective stroke registry in Japan. Logistic regression analysis was performed to estimate the risk of unfavorable outcomes in women after adjusting for potential confounders. The interactions between sex and confounders were also assessed. Among 6848 patients who survived for 5 years poststroke, 39.3% were female. Female survivors were more likely to experience unfavorable functional outcomes throughout 5 years post-stroke than male survivors. The higher risk of functional worsening in women than men was more apparent among patients aged > 75 years and those without limb weakness (P for interaction for age 0.04 and for limb weakness 0.03). Older female patients, frequently experiencing frailty and multimorbidity, should be targeted in poststroke interventions to reduce the burden of long-term disability after stroke. Female patients without apparent motor impairment might also benefit from physical activity programs to maintain muscle strength.