Study finds small sex differences in recovery after ischemic stroke

When examining recovery during the first year after an ischemic stroke, a new study has found for daily tasks such as eating, dressing and driving, female participants experienced slightly worse recovery than male participants. The study was published December 17, 2025, in Neurology^®, the medical journal of the American Academy of Neurology. Ischemic stroke, the most common type of stroke, is when blood flow is blocked to part of the brain.

Stroke is a leading cause of disability in the U.S. and with the aging population, the number of stroke survivors is growing. Since many people live with physical, cognitive and emotional challenges after stroke, it is important to find ways to improve recovery. Our study provides a better understanding of sex differences during stroke recovery."

Chen Chen, PhD, study author, University of Michigan, Ann Arbor

For the study, researchers identified 1,046 people who experienced their first ischemic stroke. Participants had an average age of 66. Researchers reviewed medical records and participant interviews to track their recovery at three, six and 12 months after stroke. Participants were given neurological assessments, cognitive tests and completed questionnaires about their quality of life.

Participants were also assessed on how well they completed daily tasks, both simple and more complex, such as walking, bathing, cooking and doing housework. A score of two indicated some difficulty completing daily tasks. A score of three indicated a lot of difficulty.

For daily tasks, female participants had higher average scores than male participants indicating poorer recovery at three, six and 12 months after stroke. For example, female participants had an average score of 2.39 and male participants had an average score of 2.04 at three months.

Scores for female participants, but not male participants, decreased from three to 12 months, indicating some improvement.

After adjusting for factors such as age, race and ethnicity, education and insurance status, researchers found female participants' average scores were higher by 0.13, 0.10 and 0.09 at three, six and 12 months, indicating poorer recovery than male participants. Chen noted the effect size was small.

While there were no sex differences in other areas of recovery, both sexes experienced improvement in neurological function, which includes communicating and performing simple movements.

"Our results suggest that early and repeated assessments of a person's ability to do daily tasks after stroke are needed, and particularly for female individuals, in order to reduce these differences in recovery," said Chen. "When developing new interventions, these recovery patterns should be considered. Since the differences were mainly in activities such as doing heavy housework, shopping and carrying heavy weights, new interventions could include muscle-strengthening activities."

A limitation of the study was that researchers did not have data on participants' use of rehabilitation services, so they were unable to evaluate the potential impact.

The study was supported by the National Institutes of Health.