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Female Gender is a Significant Risk Factor for Functional Disability After Hemorrhagic Stroke but Not Ischemic Stroke Among Japanese Community-Dwelling Elderly Individuals

Circulation(2019)

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摘要
Introduction: Previous studies have indicated that the female gender is one of the important risk factors for disability after stroke; however, most studies have been conducted in Western countries, and the higher risk of disability after stroke observed in women is thought to be different in Japan, where the proportion of hemorrhagic stroke (HS) is relatively higher than that in Western countries. Hypothesis: We assessed the hypothesis that the higher risk of disability after stroke attributable to the female gender was different between ischemic stroke (IS) and HS. Methods: We used 10-year community-based cohort data of 8,698 participants aged 65 years or older without cardiovascular disease or long-term care insurance (LTCI) at the time of the baseline survey. The stroke incidence was confirmed by reviewing the Iwate Stroke Registry. Functional disability was defined as being newly certified by the LTCI system. Participants were classified into three groups: G1, event-free (no stroke and no disability, n=7,950); G2, no disability after stroke (IS=177, HS=55); and G3, disability after stroke (IS=346, HS=170). Multivariate-adjusted odds ratios (ORs) of the female gender in G2 and G3 (reference: G1) were calculated using multinomial logistic regression with adjustments for age, hypertension, diabetes, dyslipidemia, overweight, current smoking, regular alcohol consumption, and regular exercise separately in those with IS and HS. Results: The ORs of the female gender were not high in G3 in IS, while the OR (95% confidence interval) was significantly high in G3 (1.55 (1.03-2.34)) in HS (see table). Conclusions: The proportion of females in the subjects with disabilities after HS was significantly higher than the proportion of males after multivariate adjustment. This suggested that the female gender was a significant risk factor for disability after HS, but not after IS in Japanese community-dwelling individuals.
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Post-Stroke Depression
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