Increased Risk for PSD in Elderly Women Following Ischemic Stroke

Shot for a senior woman looking thoughtfully out of a window
At the 2021 International Stroke Conference, researchers presented their findings on the differences in poststroke depression between elderly men and women.

Elderly women who are stroke patients are more susceptible to the development of poststroke depression (PSD) than their male counterparts, according to study findings presented at the International Stroke Conference, held remotely from March 17 to 19, 2021.

The conflicting evidence on sex differences in PSD led study researchers to further examine their effects on PSD risk and time course in patients with ischemic stroke (IS). They used a retrospective cohort study consisting of fully deidentified data for US Medicare beneficiaries. The patients were at least 65 years old and had been admitted for IS between July 2016 and December 2017.

Study researchers then calculated a Kaplan-Meier unadjusted cumulative risk of depression for up to 1.5 years following admission. They used a Cox regression model to identify hazard ratio (HR) for diagnosis of depression in men vs women. Results were adjusted for patient demographics, length of stay, comorbidities, and acute stroke interventions.

Of the patients analyzed in the study, women (n=90,474) were identified as having a 20% higher risk of developing PSD than men (n=84,427). Findings indicated that the risk of depression was increased for women (HR, 0.2055; 95% CI, 0.2013-0.2097) over the 1.5 year follow-up (log-rank P <.0001) when compared with the risk for men (HR, 0.1690; 95% CI, 0.1639-0.1741) developing PSD. Additionally, there was a significant HR in the fully adjusted analysis of PSD in females vs males (HR, 1.20; 95% CI, 1.17-1.23; P <.0001).

Based on these findings, the study researchers concluded that the increased risk of elderly females developing PSD following IS encourages “the need for long-term depression screening” and “further investigation of underlying reasons for sex differences.”


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