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Sex Differences in Poststroke Cognitive Impairment: A Multicenter Study in 2343 Patients With Acute Ischemic Stroke

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  • معلومة اضافية
    • Contributors:
      Utrecht Brain Center UMC; University Medical Center Utrecht (UMCU); Image sciences institute - University of Utrecht (ISI); Elisabeth-TweeSteden Hospital; Seoul National University Bundang Hospital (SNUBH); UCL Institute of Neurology, Queen Square London; Lille Neurosciences & Cognition - U 1172 (LilNCog); Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire CHU Lille (CHRU Lille); Department of Pharmacology, Yong Loo Lin School of Medicine Singapour; National University of Singapore (NUS); Yong Loo Lin School of Medicine Singapore; Department of Neurology Erasmus MC, Rotterdam; Erasmus University Medical Center Rotterdam (Erasmus MC); Laboratoire de Neurosciences Fonctionnelles et Pathologies - UR UPJV 4559 (LNFP); Université de Picardie Jules Verne (UPJV); CHU Amiens-Picardie; National University Health System Singapore (NUHS); Center for Clinical Brain Sciences (CCBS); University of Edinburgh (Edin.); UK Dementia Research Institute (UK DRI); University College of London London (UCL); MRC/CSO Social and Public Health Sciences Unit Glasgow, UK; Institute of Health and Wellbeing; College of Medical, Veterinary and Life Sciences Glasgow; University of Glasgow-University of Glasgow-College of Medical, Veterinary and Life Sciences Glasgow; University of Glasgow-University of Glasgow; Saw Swee Hock School of Public Health; Helmholtz Institute Utrecht; School for Mental Health and Neuroscience Maastricht (MHeNs); Maastricht University Maastricht; Asan Medical Center Seoul; University of Ulsan; Institute of Applied Health Sciences; University of Aberdeen; Department of Medicine and Therapeutics Hong Kong; The Chinese University of Hong Kong Hong Kong (CUHK); Gerald Choa Neuroscience Institute (GCNI); Maastricht University Medical Centre (MUMC); Raffles Neuroscience Centre Singapour; Raffles Hospital Singapour; Diakonessenhuis Hospital Utrecht
    • بيانات النشر:
      HAL CCSD
      American Heart Association
    • الموضوع:
      2023
    • نبذة مختصرة :
      International audience ; Background: Poststroke cognitive impairment (PSCI) occurs in about half of stroke survivors. Cumulative evidence indicates that functional outcomes of stroke are worse in women than men. Yet it is unknown whether the occurrence and characteristics of PSCI differ between men and women. Methods: Individual patient data from 9 cohorts of patients with ischemic stroke were harmonized and pooled through the Meta-VCI-Map consortium (n=2343, 38% women). We included patients with visible symptomatic infarcts on computed tomography/magnetic resonance imaging and cognitive assessment within 15 months after stroke. PSCI was defined as impairment in ≥1 cognitive domains on neuropsychological assessment. Logistic regression analyses were performed to compare men to women, adjusted for study cohort, to obtain odds ratios for PSCI and individual cognitive domains. We also explored sensitivity and specificity of cognitive screening tools for detecting PSCI, according to sex (Mini-Mental State Examination, 4 cohorts, n=1814; Montreal Cognitive Assessment, 3 cohorts, n=278). Results: PSCI was found in 51% of both women and men. Men had a lower risk of impairment of attention and executive functioning (men: odds ratio, 0.76 [95% CI, 0.61–0.96]), and language (men: odds ratio, 0.67 [95% CI, 0.45–0.85]), but a higher risk of verbal memory impairment (men: odds ratio, 1.43 [95% CI, 1.17–1.75]). The sensitivity of Mini-Mental State Examination (<25) for PSCI was higher for women (0.53) than for men (0.27; P =0.02), with a lower specificity for women (0.80) than men (0.96; P =0.01). Sensitivity and specificity of Montreal Cognitive Assessment (<26.) for PSCI was comparable between women and men (0.91 versus 0.86; P =0.62 and 0.29 versus 0.28; P =0.86, respectively). Conclusions: Sex was not associated with PSCI occurrence but affected domains differed between men and women. The latter may explain why sensitivity of the Mini-Mental State Examination for detecting PSCI was higher in women with a lower ...
    • Relation:
      hal-04179886; https://u-picardie.hal.science/hal-04179886; https://u-picardie.hal.science/hal-04179886/document; https://u-picardie.hal.science/hal-04179886/file/Exalto_etal_S_Sex_Differences_In_VOR.pdf
    • الرقم المعرف:
      10.1161/STROKEAHA.123.042507
    • Rights:
      info:eu-repo/semantics/OpenAccess
    • الرقم المعرف:
      edsbas.76FE9FEB