Men Are at Higher Risk of Screening Positive for Vascular Cognitive Impairment Compared to Women after Stroke and Transient Ischemic Attack

Article type: Short Communication

Authors: Zinman, Julia^a | Kapoor, Arunima^a | Si, Kevin^{a; b} | Sujanthan, Sajeevan^{a; b} | Southwell, Alisia^a | Cayley, Megan L.^a | Sicard, Michelle N.^a | Lien, Karen^a | Murray, Brian J.^a | Lanctôt, Krista^{b; c} | Herrmann, Nathan^{b; c} | Dowlatshahi, Dar^d | Sahlas, Demetrios J.^e | Saposnik, Gustavo^f | Mandzia, Jennifer L.^g | Casaubon, Leanne K.^h | Hassan, Aymanⁱ | Perez, Yael^j | Swartz, Richard H.^{a; b; *}

Affiliations: [a] Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, Toronto, ON, Canada | [b] University of Toronto, Toronto, ON, Canada | [c] Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada | [d] Department of Medicine, University of Ottawa and Ottawa Hospital Research Institute, Ottawa, ON, Canada | [e] Department of Medicine (Neurology), McMaster University, Hamilton General Hospital, Hamilton Health Sciences, Hamilton, ON, Canada | [f] Stroke Outcomes and Decision Neuroscience Unit, St. Michael’s Hospital, Toronto, ON, Canada | [g] London Health Sciences Centre, Division of Neurology, London, ON, Canada | [h] University Health Network/Toronto Western Hospital, Division of Neurology, Toronto, ON, Canada | [i] Thunder Bay Regional Health Sciences Centre, Division of Neurology, Thunder Bay, ON, Canada | [j] Trillium Health Partners, Department of Medicine (Neurology), Mississauga, ON, Canada

Correspondence: [*] Correspondence to: Richard H. Swartz, MD, PhD, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Toronto, ON M4 N 3M5, Canada. Tel.: +1 416 480 4866; E-mail: rick.swartz@sunnybrook.ca.

Abstract: While women have greater incidence of dementia, men have higher prevalence of vascular risk factors. This study examined sex differences in risk of screening positive for cognitive impairment after stroke. Ischemic stroke/TIA patients (N = 5969) participated in this prospective, multi-centered study, which screened for cognitive impairment using a validated brief screen. Men showed a higher risk of screening positive for cognitive impairment after adjusting for age, education, stroke severity, and vascular risk factors, suggesting that other factors may be contributing to increased risk among men (OR = 1.34, CI 95% [1.16, 1.55], p < 0.001). The effect of sex on cognitive impairment after stroke warrants further attention.

Keywords: Alzheimer’s disease, cognitive impairment, sex difference, stroke, transient ischemic attack

DOI: 10.3233/JAD-230021

Journal: Journal of Alzheimer's Disease, vol. 94, no. 1, pp. 89-94, 2023