Background. Little is known about sex differences in stroke recovery. The few available studies have found that women are less likely to achieve independence in activities of daily living (ADL) and have poorer quality of life (QOL). Methods. A total of 373 stroke survivors from a hospital-based stroke registry were enrolled in the MASCOTS Outcomes Study. Follow-up data, including the Barthel Index (BI) and Stroke-Specific Quality of Life (SS-QOL), were obtained by telephone interview 90 days post-stroke. The independent effects of sex on ADL independence (BI≥95), controlling for age, race, stroke subtype, and other patient characteristics, were determined by logistic regression, and on SS-QOL scores by linear regression. Two-way interactions were considered. Least-squares means for SS-QOL scores were calculated to summarize the independent effects of sex. Results. Follow-up information was obtained on 72% (N=273) subjects. In adjusted models, males were more likely than females to achieve ADL independence (OR 2.75, 95% CI 1.49-5.08). Females had lower adjusted SS-QOL scores in Physical Function, Thinking, Language, and Energy. Interactions between sex and diabetes history, prior stroke, or interview source were found for Mood, Role Function, Vision and Summary Scores. Conclusions. Females are at a disadvantage in stroke recovery. These differences are not explained by females' greater age at stroke onset or other measured patient characteristics.
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