University of Belgrade
Faculty for Special Education and Rehabilitation
Aleksandra M. Pavlovic is an Assistant Professor of Neurology and Neuropsychology at the Faculty for Special Education and Rehabilitation and the Department of Psychology of the Faculty of Psychology at the University of Belgrade, Serbia. She is a consultant neurologist with over 25 years of experience, trained in stroke neurology, neuropsychology, and neurosonology in Serbia, Israel, the USA, Austria, and Australia. Dr. Pavlovic received her Ph.D. in neurology, completing a doctoral thesis on cerebral small vessel disease. She is a Fellow of the ESO, a member of the Dementia Committee, and the Membership Committee of the ESO. Dr. Pavlovic also served as a chair of the ESO-research group WISE – Women Initiative for Stroke in Europe. Dr. Pavlovic is also a member of the Education Committee of the European Stroke Conference for 2021 and 2022. Dr. Pavlovic co-authored the Serbian National Guidelines for Ischemic Stroke (2011) and National Guidelines for Alzheimer’s disease (2013). Her research interest focuses on small vessel disease, rare causes of stroke, dementia, cognitive and behavioral neurology, migraine, and neurosonology. She published over 70 peer-reviewed papers and co-authored six books on these topics.

Presenter of 1 Presentation

FEMALE SEX IS A RISK FACTOR FOR COGNITIVE DECLINE IN CEREBRAL SMALL-VESSEL DISEASE

Session Type
Free Communication Session
Date
28.10.2021, Thursday
Session Time
17:45 - 19:15
Room
FREE COMMUNICATIONS A
Lecture Time
18:35 - 18:45

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.

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