Abstract
BackgroundStudies have suggested that aphasia rates are different in men and women following stroke. One hypothesis says that men have more lateralized language function than women. Given unilateral stroke, this would lead to a prediction of men having higher aphasia rates than women. Another line of observations suggest that women are more severely affected by stroke, which could lead to a higher aphasia rate among women. An additional potential confounding variable could be age, given that women are typically older at the time of stroke.Methods & proceduresThis study consists of two parts. First, a meta-analysis of the available reports of aphasia rates in the two sexes was conducted. A comprehensive literature search yielded 25 studies with sufficient information about both aphasia and gender. These studies included a total of 48,362 stroke patients for which aphasia rates were calculated. Second, data were extracted from an American health database (with 1,967,038 stroke patients), in order to include age and stroke severity into a regression analysis of sex differences in aphasia rates.Outcomes & resultsBoth analyses revealed significantly larger aphasia rates in women than in men (1.1–1.14 ratio). This speaks against the idea that men should be more lateralized in their language function. When age and stroke severity were included as covariates, sex failed to explain any aphasia rate sex difference above and beyond that which is explained by age differences at time of stroke.
Highlights
A stroke is a medical condition in which blood flow to the brain is restricted, due to occlusion or hemorrhage, resulting in cell death (WHO)
A recent meta-analysis, concluded that aphasia is present in approximately 30% of acute patients and 34% in rehabilitation settings [6]
The effect size, as measured by Cohen’s d, was found to be larger in the database-analysis (0.63) than in the meta-analysis (0.37). This is likely due to the fact that the database data is much more homogeneous than the data included in the meta-analysis, where the publication time differs substantially, the time of diagnosis post-stroke differs and the definition of aphasia differs to some extent
Summary
A stroke is a medical condition in which blood flow to the brain is restricted, due to occlusion (ischemic stroke) or hemorrhage (hemorrhagic stroke), resulting in cell death (WHO). The method for aphasia identification differs between hospitals and countries and some sub-scores for aphasia in stroke scales have been found to be limited in their accuracy and reliability [7, 8]. Another potential source of variance may be sex. Studies have suggested that aphasia rates are different in men and women following stroke. One hypothesis says that men have more lateralized language function than women. Given unilateral stroke, this would lead to a prediction of men having higher aphasia rates than women. An additional potential confounding variable could be age, given that women are typically older at the time of stroke
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