Department of Neurology, University of Texas Health Science Center at Houston (B.M., C.F.).
Department of Epidemiology, University of Michigan, Ann Arbor (L.L.).
Stroke. 2022 Aug;53(8):2662-2672. doi: 10.1161/STROKEAHA.121.036894. Epub 2022 Jun 2.
Stroke risk and prevalence increase with advanced age and women tend to be older than men at the time of their first stroke. Advanced age in women confers unique stroke risks that are beyond reproductive factors. Previous reviews and guidelines have largely focused on risk factors specific to women, with a predominant focus on reproductive factors and, therefore, younger to middle-aged women. This review aims to specifically describe stroke risk factors in elderly women, the population of women where the majority of strokes occur, with a focus on atrial fibrillation, hormone therapy, psychosocial risk factors, and cognitive impairment. Our review suggests that prevention and management of stroke risks that are unique or more prevalent in elderly women needs a coordinated system of care from general physicians, general neurologists, vascular and cognitive neurologists, psychologists, cardiologists, patients, and their caretakers. Early identification and management of the elderly woman-specific and traditional stroke risk factors is key for decreasing stroke burden in elderly women. Increased education among elderly women regarding stroke risk factors and their identification should be considered, and an update to the guidelines for prevention of stroke in women is strongly encouraged.
中风风险和患病率随着年龄的增长而增加，女性在首次中风时往往比男性年龄大。女性的高龄会带来独特的中风风险，这些风险超出了生育因素的范畴。以前的综述和指南主要集中在针对女性的特定风险因素上，主要关注生育因素和因此处于中青年的女性。本综述旨在专门描述老年女性的中风风险因素，即中风发生的大多数人群，重点关注房颤、激素治疗、社会心理风险因素和认知障碍。我们的综述表明，预防和管理老年女性特有的或更为普遍的中风风险需要一个由普通内科医生、普通神经科医生、血管和认知神经科医生、心理学家、心脏病专家、患者及其护理人员共同组成的协调护理系统。早期识别和管理老年女性特有的和传统的中风风险因素是降低老年女性中风负担的关键。应该考虑提高老年女性对中风风险因素及其识别的教育水平，并强烈鼓励更新女性中风预防指南。
