Increased risk of PSD in older women after an ischemic stroke

Older women who have had a stroke are more prone to developing post-stroke depression (PSD) than their male counterparts. This is evident from study results that were remotely presented at the International Stroke Conference March 17-19, 2021.

The conflicting evidence on gender differences in PSD led the study researchers to further investigate its effects on PSD risk and time course in ischemic stroke (IS) patients. They used a retrospective cohort study that consisted of completely unidentified data for US Medicare beneficiaries. Patients were at least 65 years old and were admitted to IS between July 2016 and December 2017.

The study researchers then calculated an unadjusted cumulative Kaplan-Meier risk for depression for up to 1.5 years after admission. They used a Cox regression model to identify the hazard ratio (HR) for diagnosing depression in men and women. The results were adjusted with regard to patient data, length of stay, comorbidities and acute stroke interventions.

Of the patients analyzed in the study, women (n = 90,474) had a 20% higher risk of developing PSD than men (n = 84,427). The results showed that the risk of depression in women (HR, 0.2055; 95% CI, 0.2013-0.2097) at 1.5-year follow-up (log rank P <0.0001) compared to the risk in men (HR, HR, increased). 0.1690; 95% CI, 0.1639-0.1741) PSD develop. In addition, there was a significant HR in the fully adjusted analysis of PSD in women versus men (HR 1.20; 95% CI 1.17-1.23; P <0.0001).

Based on these results, the researchers concluded that the increased risk of older women developing PSD after IS, encourages “the need for long-term depression screening” and “further investigation into the underlying causes of gender differences”.


Mayman N., Tuhrim S., Jette N., Dhamoon MS, Stein LK. Gender differences in post-stroke depression in the elderly. Presented at: International Stroke Conference; 17th-19th March 2021. Presentation 22.


Cardiology depression health disparity stroke women’s health

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