Women Face Greater Challenges Than Men in Daily Task Recovery After Ischemic Stroke, New Study Finds

Recovery after a stroke is rarely simple, and new research suggests that women may face slightly greater challenges than men when it comes to regaining independence in everyday activities. A large study published in the journal Neurology has taken a close look at how people recover during the first year after an ischemic stroke and found consistent, though modest, differences between female and male patients in their ability to perform daily tasks.

Ischemic stroke is the most common type of stroke, occurring when blood flow to part of the brain is blocked. It is also a leading cause of long-term disability, especially as populations age and more people survive strokes. Understanding who recovers faster, who struggles more, and why these differences exist is critical for improving rehabilitation and long-term outcomes.

This study adds important detail to that conversation by focusing on functional recovery, particularly the ability to manage day-to-day activities that define independence and quality of life.

How the Study Was Designed

Researchers analyzed data from 1,046 people who experienced their first-ever ischemic stroke. All participants were tracked over the course of one year, with follow-up assessments conducted at three months, six months, and 12 months after the stroke.

The average age of participants was 66 years, placing most of them in an age group where stroke risk and recovery challenges are especially relevant. Researchers relied on a combination of medical record reviews and structured participant interviews to gather detailed information about recovery progress.

Participants underwent:

Neurological assessments to evaluate movement, coordination, and communication
Cognitive tests to measure thinking and memory
Quality-of-life questionnaires
Functional assessments focused on daily activities

A major part of the study involved scoring how well participants could complete both basic and more complex daily tasks, including walking, bathing, eating, dressing, cooking, housework, shopping, and driving.

The scoring system was straightforward:

A score of two indicated some difficulty completing daily tasks
A score of three indicated a lot of difficulty

Higher scores meant poorer functional recovery.

Clear Differences in Daily Task Recovery

Across all three time points—three, six, and 12 months—women consistently had higher average scores than men, indicating more difficulty with daily tasks.

At the three-month mark, for example:

Women had an average score of 2.39
Men had an average score of 2.04

This pattern held steady throughout the year. Even though both men and women showed signs of recovery, women remained at a slight disadvantage in functional independence.

An interesting detail emerged over time. Women’s scores gradually decreased between three and 12 months, suggesting improvement, while men’s scores remained relatively stable. Despite this improvement, women still did not fully catch up to men in daily task performance by the end of the year.

Adjusting for Other Factors

To make sure these differences were not explained by unrelated factors, researchers adjusted their analysis for several variables, including:

Age
Race and ethnicity
Level of education
Insurance status

Even after these adjustments, women continued to show poorer average functional scores:

0.13 points higher at three months
0.10 points higher at six months
0.09 points higher at 12 months

The study authors emphasized that the effect size was small, meaning the differences were not dramatic. However, the consistency of the findings across multiple time points suggests the pattern is real and meaningful, especially when viewed at a population level.

Where the Differences Were Most Noticeable

The sex differences did not appear in every aspect of recovery. In fact, both women and men showed similar improvements in neurological function, such as basic movement and communication abilities.

The gap was most evident in activities that require strength, coordination, or endurance, including:

Heavy housework
Shopping
Carrying heavy objects

These tasks often demand more physical effort than basic self-care activities, which may help explain why differences emerged here rather than in simpler movements.

Why These Findings Matter

Daily tasks are not just routine chores. They are closely tied to independence, confidence, and quality of life. Difficulty with activities like shopping, cooking, or driving can limit social engagement, increase reliance on caregivers, and affect mental health.

The study suggests that early and repeated assessments of daily task performance could be especially important for women after stroke. Identifying difficulties sooner may allow healthcare providers to tailor rehabilitation strategies before gaps widen.

Researchers also noted that future interventions might benefit from placing greater emphasis on muscle-strengthening and functional training, particularly for activities that showed the largest differences between women and men.

A Key Limitation to Keep in Mind

One important limitation of the study was the lack of data on rehabilitation services. Researchers did not know:

How many participants received physical or occupational therapy
How often therapy sessions occurred
Whether rehabilitation programs differed between men and women

Without this information, it is impossible to determine how much access to or use of rehabilitation services influenced recovery outcomes.

What Else We Know About Stroke Recovery and Sex Differences

Previous research has shown that women often experience strokes at older ages than men and may have more pre-existing health conditions, both of which can affect recovery. Social factors also play a role. Women are more likely to live alone later in life and may have less informal caregiving support during recovery.

Biological differences, including muscle mass, hormonal influences, and cardiovascular health, may also contribute to variations in post-stroke recovery. However, no single factor fully explains the differences seen in this study, reinforcing the idea that recovery is shaped by a complex mix of biological, social, and healthcare-related influences.

Why This Study Adds Value

What makes this research especially valuable is its large sample size, year-long follow-up, and focus on real-world functional outcomes. Instead of looking only at survival or basic neurological measures, it zeroes in on what recovery actually feels like in daily life.

The findings do not suggest that women recover poorly overall, but rather that their recovery trajectory may differ in subtle but important ways. Recognizing these patterns can help clinicians design more personalized and effective rehabilitation programs.

As the number of stroke survivors continues to rise, studies like this highlight the importance of tailoring care to individual needs, rather than assuming recovery looks the same for everyone.

Research paper: https://n.neurology.org/