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Poststroke Cognitive Outcomes: Sex Differences and Contributing Factors

BACKGROUND: The study investigated sex differences in cognitive outcomes at 90 days after first‐ever stroke using data from a population‐based sample. METHODS AND RESULTS: The study sample consisted of 1227 participants from the 2009–2016 Brain Attack Surveillance in Corpus Christi project (south Te...

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Autores principales: Dong, Liming, Briceno, Emily, Morgenstern, Lewis B., Lisabeth, Lynda D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7660722/
https://www.ncbi.nlm.nih.gov/pubmed/32633589
http://dx.doi.org/10.1161/JAHA.120.016683
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author Dong, Liming
Briceno, Emily
Morgenstern, Lewis B.
Lisabeth, Lynda D.
author_facet Dong, Liming
Briceno, Emily
Morgenstern, Lewis B.
Lisabeth, Lynda D.
author_sort Dong, Liming
collection PubMed
description BACKGROUND: The study investigated sex differences in cognitive outcomes at 90 days after first‐ever stroke using data from a population‐based sample. METHODS AND RESULTS: The study sample consisted of 1227 participants from the 2009–2016 Brain Attack Surveillance in Corpus Christi project (south Texas, United States) who had first‐ever ischemic stroke or intracerebral hemorrhage and survived 90 days after stroke. Poststroke cognitive function was assessed by the Modified Mini‐Mental State Examination (3MSE) (range: 0–100; dementia: <78). The associations of sex with dichotomized and continuous outcomes were examined using logistic regression and tobit regression, respectively. Inverse probability weighting and multiple imputation were used to deal with missing data. The study sample was evenly distributed by sex, and primarily composed of Mexican Americans (59.1%) and non‐Hispanic whites (34.1%). Women scored 2.96 points worse on the 3MSE than men at 90 days poststroke (95% CI, −3.99 to −1.93). The prevalence of dementia was 27.6% for men (95% CI, 23.5%–31.6%) and 35.6% for women (95% CI, 31.5%–39.7%), and the unadjusted odds ratio (OR) of dementia comparing women with men was 1.45 (95% CI, 1.24–1.69). The association was attenuated after adjustment for sociodemographic, stroke, and prestroke characteristics (OR, 0.82; 95% CI, 0.61–1.09). CONCLUSIONS: Women had worse cognitive outcomes than men at 90 days poststroke. The differences were attributable to sociodemographic and prestroke characteristics, especially widowhood status. Potential mechanisms linking widowhood to dementia in the acute poststroke stage warrant further investigation to inform interventions addressing the unique care needs of women stroke survivors with dementia and cognitive dysfunction.
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spelling pubmed-76607222020-11-17 Poststroke Cognitive Outcomes: Sex Differences and Contributing Factors Dong, Liming Briceno, Emily Morgenstern, Lewis B. Lisabeth, Lynda D. J Am Heart Assoc Original Research BACKGROUND: The study investigated sex differences in cognitive outcomes at 90 days after first‐ever stroke using data from a population‐based sample. METHODS AND RESULTS: The study sample consisted of 1227 participants from the 2009–2016 Brain Attack Surveillance in Corpus Christi project (south Texas, United States) who had first‐ever ischemic stroke or intracerebral hemorrhage and survived 90 days after stroke. Poststroke cognitive function was assessed by the Modified Mini‐Mental State Examination (3MSE) (range: 0–100; dementia: <78). The associations of sex with dichotomized and continuous outcomes were examined using logistic regression and tobit regression, respectively. Inverse probability weighting and multiple imputation were used to deal with missing data. The study sample was evenly distributed by sex, and primarily composed of Mexican Americans (59.1%) and non‐Hispanic whites (34.1%). Women scored 2.96 points worse on the 3MSE than men at 90 days poststroke (95% CI, −3.99 to −1.93). The prevalence of dementia was 27.6% for men (95% CI, 23.5%–31.6%) and 35.6% for women (95% CI, 31.5%–39.7%), and the unadjusted odds ratio (OR) of dementia comparing women with men was 1.45 (95% CI, 1.24–1.69). The association was attenuated after adjustment for sociodemographic, stroke, and prestroke characteristics (OR, 0.82; 95% CI, 0.61–1.09). CONCLUSIONS: Women had worse cognitive outcomes than men at 90 days poststroke. The differences were attributable to sociodemographic and prestroke characteristics, especially widowhood status. Potential mechanisms linking widowhood to dementia in the acute poststroke stage warrant further investigation to inform interventions addressing the unique care needs of women stroke survivors with dementia and cognitive dysfunction. John Wiley and Sons Inc. 2020-07-07 /pmc/articles/PMC7660722/ /pubmed/32633589 http://dx.doi.org/10.1161/JAHA.120.016683 Text en © 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Dong, Liming
Briceno, Emily
Morgenstern, Lewis B.
Lisabeth, Lynda D.
Poststroke Cognitive Outcomes: Sex Differences and Contributing Factors
title Poststroke Cognitive Outcomes: Sex Differences and Contributing Factors
title_full Poststroke Cognitive Outcomes: Sex Differences and Contributing Factors
title_fullStr Poststroke Cognitive Outcomes: Sex Differences and Contributing Factors
title_full_unstemmed Poststroke Cognitive Outcomes: Sex Differences and Contributing Factors
title_short Poststroke Cognitive Outcomes: Sex Differences and Contributing Factors
title_sort poststroke cognitive outcomes: sex differences and contributing factors
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7660722/
https://www.ncbi.nlm.nih.gov/pubmed/32633589
http://dx.doi.org/10.1161/JAHA.120.016683
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