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Sex differences in stroke: a socioeconomic perspective

Authors Delbari A, Keyghobadi F, Momtaz YA, Keyghobadi F, Akbari R, Kamranian H, Yazdi MS, Tabatabaei SS, Fereshtehnejad SM

Received 21 May 2016

Accepted for publication 8 July 2016

Published 6 September 2016 Volume 2016:11 Pages 1207—1212

DOI https://doi.org/10.2147/CIA.S113302

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 4

Editor who approved publication: Dr Richard Walker

Ahmad Delbari,1 Farzane Keyghobadi,2 Yadollah Abolfathi Momtaz,1,3 Fariba Keyghobadi,2 Reza Akbari,2 Houman Kamranian,2 Mohammad Shouride Yazdi,2 Sayed Shahaboddin Tabatabaei,1 Seyed-Mohammad Fereshtehnejad4

1Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran; 2Research Center on Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar, Khorasan, Iran; 3Malaysian Research Institute on Ageing (MyAgeing™), Universiti Putra Malaysia, Serdang, Selangor, Malaysia; 4Department of Neurobiology, Division of Clinical Geriatrics, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden

Background: A number of studies have explored the issue of sex differences in stroke from biomedical perspective; however, there are still large gaps in the existing knowledge. The purpose of this study was to assess whether the differences in socioeconomic status and living conditions between men and women may explain the part of the sex differences in incidence and outcomes of stroke.
Methods: All stroke participants aged ≥60 years admitted in Vaseie Hospital in Sabzevar, Iran, from March 21, 2013, until March 20, 2014, were included in this study. Computerized tomography and magnetic resonance imaging were used to confirm stroke. A series of χ2 tests were performed and Statistical Program for Social Sciences, Version 21.0, was used to investigate the potential differences between older men and women in stroke incidence and outcomes.
Results: A total of 159 incident stroke cases were documented during 1 year. The annual rate of stroke was statistically significantly higher in elderly women than in elderly men (401 vs 357 per 100,000; P<0.001). Female elderly participants had significantly lower socioeconomic status, poorer living conditions, and higher lifetime history of depression, hypertension, and diabetes mellitus than their male counterparts.
Conclusion: The findings from this study showed that elderly women are more adversely affected by stroke in terms of incidence and outcomes of stroke than elderly men. The most noticeable result is that sex differences in socioeconomic status and living conditions may result in increased incidence of stroke and poorer outcomes in elderly women. Therefore, it is imperative to identify vulnerable elderly women and provide them appropriate treatment and services.

Keywords:
aged, incidence, mortality, outcome, sex differences, socioeconomic disparities, vascular disease

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