Women Had Tougher Time Post-Stroke

Stroke survivor quality of life lower in women in the first year after ischemic stroke or transient ischemic attack

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) A stroke is a serious health event for anyone who experiences one. But could the recovery period be worse for women? A new study suggests that females may have a tougher time after a stroke.

The researchers behind this new study measured quality of life three months and one year after a stroke.

The study showed that women had a worse quality of life than men three months after a stroke, including more problems with mobility and depression, though the scores evened out a bit at the one-year mark.

"Seek care immediately if one side of the body goes numb."

In an ischemic stroke, which the American Stroke Association (ASA) says is the most common type of stroke, there is a blockage in a blood vessel that sends blood to the brain. Permanent brain damage can develop.

In a transient ischemic attack (TIA), or "mini-stroke," a similar blockage occurs, but the blockage is only temporary and the attack is very short-lived. According to ASA, TIAs are a serious warning sign, though permanent effects may not be seen.

In this new study, which was led by Cheryl Bushnell, MD, of the Wake Forest School of Medicine in Winston-Salem, North Carolina, the researchers aimed to explore gender differences in quality of life following an ischemic stroke or TIA.

The researchers utilized the National Adherence Evaluation After Ischemic Stroke—Longitudinal (AVAIL) Registry to identify 1,370 patients between the ages of 56 and 77. Just about half of the patients were male (53.7 percent) and the rest were female.

Quality of life was assessed three months and one year after the patient's stroke or TIA using the European Quality of Life—5 Dimensions (EQ-5D) scale. The patients were asked about mobility, self-care, their usual activities, depression or anxiety and pain. The highest possible score using this scale was 1.0 and the lowest possible score was -0.11.

Dr. Bushnell and team found that at the three-month mark, women had a lower quality of life. The women's average EQ-5D score was 0.81, while the men's average score was 0.84.

Three months after a stroke or TIA, around 50 percent of women reported having no mobility issues, compared to nearly 60 percent of men.

At the twelve-month mark, the differences between quality of life scores for the genders had evened out a little bit — the women's average score at this point was 0.83, while the men scored 0.84.

"This article is in line with prior investigations done into this issue. Women and minorities, especially African Americans, have been shown to have worse outcomes compared with other populations," said Osman Mir, MD, an inpatient hospitalist at Baylor University Medical Center at Dallas.

"There is some evidence that this might be due to the decreased IV t-pa treatment. It is not clear that the authors of this study take that into account. However, they do dissect the outcome in regards to timeline of this difference in outcome," Dr. Mir told dailyRx News.

In a news release from Wake Forest Baptist Medical Center, Dr. Bushnell explained that stroke patients are living longer, bringing quality of life issues more to the forefront.

"As more people survive strokes, physicians and other healthcare providers should pay attention to quality of life issues and work to develop better interventions, even gender-specific screening tools, to improve these patients' lives," said Dr. Bushnell.

The researchers noted that the quality of life measurement scale used in this study is not specific to stroke patients, and that further research is needed on the topic.

This study was published online February 7 in the journal Neurology.

The registry used to identify patients was supported by Bristol-Myers Squibb/Sanofi Joint Partnership. Dr. Bushnell has received a research salary from this group as well. A number of other authors reported receiving compensation or funding from a variety of pharmaceutical companies and organizations.

Last Updated:
February 13, 2014