Gender Differences in Subacute Post-Stroke Patients During Rehabilitation: Functional, Cognitive, and Nutritional Insights

Background/Objectives: Despite the well-documented gender differences observed during hospitalisation, research in post-stroke recovery remains limited. This study aims to clarify this topic in subacute post-stroke patients undergoing rehabilitation, considering not only functional and cognitive outcomes but also nutritional status and food consumption. Methods: At admission (T0), patients were assessed for demographic, anamnestic, and clinical data and were diagnosed for malnutrition according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. At T0 and after a six-week rehabilitation program (T1), nutritional status was assessed by anthropometric measurements, serum analysis of albumin, glucose, lipidic, metal, and oxidative stress panel, and the calculation of the Geriatric Nutritional Risk Index; food consumption was recorded daily. Functional independence in Activities of Daily Living was measured at both T0 and T1 by the modified Barthel Index (mBI), and cognitive impairment was assessed by the Montreal Cognitive Assessment (MoCA), adjusted for age and education. Results: We enrolled 87 patients (mean age 69 ± 12 years; 42 women and 45 men); of these 52.4% of women were malnourished, compared to 33.3% of men. After rehabilitation (T1), women showed higher oxidative stress (549 ± 143 vs. 491 ± 121 UCARR; p = 0.041) and poorer functional outcomes (55.3 ± 26.1 vs. 67.1 ± 21.8; p = 0.032), despite similar cognitive improvements (19.5 ± 6.4 vs. 21.9 ± 5.2; p = 0.060) compared with men. Conclusions: This study highlights the importance of personalised treatment strategies that account for gender-specific differences to optimise recovery in post-stroke patients.