Hugo Aben (Netherlands)
Elisabeth Tweesteden Hospital NeurologyAuthor Of 1 Presentation
SEX DIFFERENCES IN OCCURRENCE AND TYPE OF POST-STROKE COGNITIVE IMPAIRMENT: A MULTICENTER STUDY IN 2950 PATIENTS WITH ACUTE ISCHEMIC STROKE
Abstract
Background And Aims
Post-stroke cognitive impairment (PSCI) occurs in about half of stroke survivors. It is unknown if occurrence and type of PSCI within a year after ischemic stroke differs by sex.
Methods
We harmonized individual patient data from twelve cohorts through the Meta-VCI-Map consortium. Patients with acute symptomatic infarcts on CT/MRI and cognitive assessment <1 year post-stroke were eligible. PSCI was defined as impairment in ≥1 cognitive domains on neuropsychological assessment or impairment on the Montreal Cognitive Assessment, both based on local norm-referenced data. Odds ratios (OR) for PSCI and the separate cognitive domains were calculated with logistic regression analyses.
Results
2950 patients (age 67±12 years, 39% female) were analyzed. Females were older (69 ±12 versus 65±11 years; p<.001) and lower educated (71% <high school versus 49%; p<.001) than males. The risk of PSCI was comparable between the sexes (males OR 0.94 (95%CI 0.81-1.09)), 45% of females and 43% of males. Females had a higher risk of impairment in the domains attention & executive functioning (males OR 0.75 (95%CI 0.60-0.94)), and language (males OR 0.67 (95%CI 0.53-0.83)), whereas males had a higher risk of verbal memory impairment (males OR 1.31 (95%CI1.08-1.59)). The risk of impairment in the other domains, information processing speed; visuospatial perception/construction; and visuospatial memory was comparable between the sexes.
Conclusions
PSCI is equally common in both females and males, but PSCI cognitive profiles differ by sex. This has implications for post-stroke clinical care, since both the diagnosis and rehabilitation are influenced by cognitive profile.
Trial Registration Number
Not applicable