Jasna Zidverc Trajkovic (Serbia)
University of Belgrade Faculty of Medicine, NeurologyAuthor Of 1 Presentation
FEMALE SEX IS A RISK FACTOR FOR COGNITIVE DECLINE IN CEREBRAL SMALL-VESSEL DISEASE
Abstract
Background and Aims
Although female sex has been implied as a negative predictor of stroke outcome in general, the long-term cognitive outcome in female compared to male survivors of acute lacunar stroke has been rarely reported. We aimed to investigate sex impact on long-term cognitive decline (CD) after the first-ever lacunar stroke.
Methods
Cognitive status was assessed in a cohort of patients with small vessel disease (SVD) four years after the qualifying event. Demographic, clinical, neuropsychological, and MRI data were compared between female and male patients.
Results
A total of 294 patients were included, 46.2% females. No difference was detected between groups regarding age or frequency of common vascular risk factors (p>0.1 for all). Brain MRI markers of SVD comprising severity scores of white matter hyperintensities and a total number of lacunar infarcts (LI) were more pronounced in female subjects (p<0.0001 for all). On follow-up, the CD was more frequently detected in women than men (78.7% vs 51.2%, p<0.0001). Multivariate regression analysis revealed that female sex was independently associated with baseline severity of MRI lesions (OR 1.38, 95%CI 1.17-1.62; p<0.0001), CD (OR 1.85, 95%CI 1.06-3.24; p=0.032), the total number of LI (OR 0.74, 95%CI 0.59-0.92; p=0.008) and modified Rankin scale score (OR 8.35, 95%CI 5.04-13.84; p<0.0001).
Conclusions
In our dataset of SVD patients, female sex was associated with more severe brain lesions, as well as an increased risk of CD and functional disability. This association could not be attributed to differences in risk factor distribution.