Sex differences in quality of life after ischemic stroke

Cheryl D. Bushnell, Mathew J. Reeves, Xin Zhao, Wenqin Pan, Janet Prvu-Bettger, Louise Zimmer, Daiwai Olson, Eric Peterson

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

Objective: We aimed to compare quality of life (QOL) in women and men after ischemic stroke or TIA, and to determine the incremental impact of demographic, socioeconomic, clinical, and stroke-specific effects on longitudinal QOL. Methods: We assessed QOL in patients with ischemic stroke or TIA at 3 and 12 months postdischarge in the Adherence eValuation After Ischemic stroke-Longitudinal Registry using the European Quality of Life-5 Dimensions (EQ-5D) instrument. We generated multivariable linear regression models to evaluate the association between sex and EQ-5D while sequentially adjusting for sociodemographic, clinical, and stroke-related variables.We also used a proportional odds model to assess sex differences in the change in EQ-5D scores from 3 to 12 months. Results: A total of 1,370 patients were included, 53.7%male, median age 65 years (interquartile range 56-77 years). Women had significantly lower QOL at 3 months (unadjusted EQ-5D 0.81 in women vs 0.84 in men; p < 0.001) and 12 months (0.83 vs men 0.84; p < 0.001) poststroke. After multivariable adjustment for sociodemographic, clinical, and stroke-related factors, women continued to have lower QOL at 3 months (mean difference -0.036; p=0.003) and at 12 months (mean difference -0.022; p = 0.046). Women fared worse in the dimensions of mobility, pain/ discomfort, and anxiety/depression at 3 and 12 months. There were no sex differences in change in EQ-5D score from 3 to 12 months. Conclusion: Women have worse QOL than men up to 12months after stroke, even after adjusting for important sociodemographic variables, stroke severity, and disability.

Original languageEnglish (US)
Pages (from-to)922-931
Number of pages10
JournalNeurology
Volume82
Issue number11
DOIs
StatePublished - Mar 18 2014

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Sex Characteristics
Stroke
Quality of Life
Linear Models
Sex Differences
Registries
Anxiety
Demography
Depression
Pain

ASJC Scopus subject areas

  • Clinical Neurology
  • Arts and Humanities (miscellaneous)

Cite this

Bushnell, C. D., Reeves, M. J., Zhao, X., Pan, W., Prvu-Bettger, J., Zimmer, L., ... Peterson, E. (2014). Sex differences in quality of life after ischemic stroke. Neurology, 82(11), 922-931. https://doi.org/10.1212/WNL.0000000000000208

Sex differences in quality of life after ischemic stroke. / Bushnell, Cheryl D.; Reeves, Mathew J.; Zhao, Xin; Pan, Wenqin; Prvu-Bettger, Janet; Zimmer, Louise; Olson, Daiwai; Peterson, Eric.

In: Neurology, Vol. 82, No. 11, 18.03.2014, p. 922-931.

Research output: Contribution to journalArticle

Bushnell, CD, Reeves, MJ, Zhao, X, Pan, W, Prvu-Bettger, J, Zimmer, L, Olson, D & Peterson, E 2014, 'Sex differences in quality of life after ischemic stroke', Neurology, vol. 82, no. 11, pp. 922-931. https://doi.org/10.1212/WNL.0000000000000208
Bushnell CD, Reeves MJ, Zhao X, Pan W, Prvu-Bettger J, Zimmer L et al. Sex differences in quality of life after ischemic stroke. Neurology. 2014 Mar 18;82(11):922-931. https://doi.org/10.1212/WNL.0000000000000208
Bushnell, Cheryl D. ; Reeves, Mathew J. ; Zhao, Xin ; Pan, Wenqin ; Prvu-Bettger, Janet ; Zimmer, Louise ; Olson, Daiwai ; Peterson, Eric. / Sex differences in quality of life after ischemic stroke. In: Neurology. 2014 ; Vol. 82, No. 11. pp. 922-931.
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abstract = "Objective: We aimed to compare quality of life (QOL) in women and men after ischemic stroke or TIA, and to determine the incremental impact of demographic, socioeconomic, clinical, and stroke-specific effects on longitudinal QOL. Methods: We assessed QOL in patients with ischemic stroke or TIA at 3 and 12 months postdischarge in the Adherence eValuation After Ischemic stroke-Longitudinal Registry using the European Quality of Life-5 Dimensions (EQ-5D) instrument. We generated multivariable linear regression models to evaluate the association between sex and EQ-5D while sequentially adjusting for sociodemographic, clinical, and stroke-related variables.We also used a proportional odds model to assess sex differences in the change in EQ-5D scores from 3 to 12 months. Results: A total of 1,370 patients were included, 53.7{\%}male, median age 65 years (interquartile range 56-77 years). Women had significantly lower QOL at 3 months (unadjusted EQ-5D 0.81 in women vs 0.84 in men; p < 0.001) and 12 months (0.83 vs men 0.84; p < 0.001) poststroke. After multivariable adjustment for sociodemographic, clinical, and stroke-related factors, women continued to have lower QOL at 3 months (mean difference -0.036; p=0.003) and at 12 months (mean difference -0.022; p = 0.046). Women fared worse in the dimensions of mobility, pain/ discomfort, and anxiety/depression at 3 and 12 months. There were no sex differences in change in EQ-5D score from 3 to 12 months. Conclusion: Women have worse QOL than men up to 12months after stroke, even after adjusting for important sociodemographic variables, stroke severity, and disability.",
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AU - Bushnell, Cheryl D.

AU - Reeves, Mathew J.

AU - Zhao, Xin

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AU - Zimmer, Louise

AU - Olson, Daiwai

AU - Peterson, Eric

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N2 - Objective: We aimed to compare quality of life (QOL) in women and men after ischemic stroke or TIA, and to determine the incremental impact of demographic, socioeconomic, clinical, and stroke-specific effects on longitudinal QOL. Methods: We assessed QOL in patients with ischemic stroke or TIA at 3 and 12 months postdischarge in the Adherence eValuation After Ischemic stroke-Longitudinal Registry using the European Quality of Life-5 Dimensions (EQ-5D) instrument. We generated multivariable linear regression models to evaluate the association between sex and EQ-5D while sequentially adjusting for sociodemographic, clinical, and stroke-related variables.We also used a proportional odds model to assess sex differences in the change in EQ-5D scores from 3 to 12 months. Results: A total of 1,370 patients were included, 53.7%male, median age 65 years (interquartile range 56-77 years). Women had significantly lower QOL at 3 months (unadjusted EQ-5D 0.81 in women vs 0.84 in men; p < 0.001) and 12 months (0.83 vs men 0.84; p < 0.001) poststroke. After multivariable adjustment for sociodemographic, clinical, and stroke-related factors, women continued to have lower QOL at 3 months (mean difference -0.036; p=0.003) and at 12 months (mean difference -0.022; p = 0.046). Women fared worse in the dimensions of mobility, pain/ discomfort, and anxiety/depression at 3 and 12 months. There were no sex differences in change in EQ-5D score from 3 to 12 months. Conclusion: Women have worse QOL than men up to 12months after stroke, even after adjusting for important sociodemographic variables, stroke severity, and disability.

AB - Objective: We aimed to compare quality of life (QOL) in women and men after ischemic stroke or TIA, and to determine the incremental impact of demographic, socioeconomic, clinical, and stroke-specific effects on longitudinal QOL. Methods: We assessed QOL in patients with ischemic stroke or TIA at 3 and 12 months postdischarge in the Adherence eValuation After Ischemic stroke-Longitudinal Registry using the European Quality of Life-5 Dimensions (EQ-5D) instrument. We generated multivariable linear regression models to evaluate the association between sex and EQ-5D while sequentially adjusting for sociodemographic, clinical, and stroke-related variables.We also used a proportional odds model to assess sex differences in the change in EQ-5D scores from 3 to 12 months. Results: A total of 1,370 patients were included, 53.7%male, median age 65 years (interquartile range 56-77 years). Women had significantly lower QOL at 3 months (unadjusted EQ-5D 0.81 in women vs 0.84 in men; p < 0.001) and 12 months (0.83 vs men 0.84; p < 0.001) poststroke. After multivariable adjustment for sociodemographic, clinical, and stroke-related factors, women continued to have lower QOL at 3 months (mean difference -0.036; p=0.003) and at 12 months (mean difference -0.022; p = 0.046). Women fared worse in the dimensions of mobility, pain/ discomfort, and anxiety/depression at 3 and 12 months. There were no sex differences in change in EQ-5D score from 3 to 12 months. Conclusion: Women have worse QOL than men up to 12months after stroke, even after adjusting for important sociodemographic variables, stroke severity, and disability.

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