Abstract Number: Esoc2026a1825 Intersectional Sex and Age Disparities in Long-Term Outcomes Post First Stroke: Findings From the Prospective South London Stroke Register

Background and aims Sex-related differences in long-term outcomes post-stroke are conflicting. Using an intersectional approach, we examined sex and age differences in long-term outcomes post-stroke. Methods 8,325 (mean age 68.8 years/47.5% female) individuals included in SLSR, a multi-ethnic population-based stroke register (1995-2025). Outcomes were functional independence (Barthel Index [BI]), daily living activities (Frenchay Activity Index [FAI]), cognitive impairment, depression/anxiety (hospital anxiety and depression scale [HADS]) assessed at baseline, 3-months, 1- and 5-years post-stroke. Individuals were grouped into: <55years male/female, 55-74years male/female or ≥75years male/female. Prevalence ratios (PR) by intersectional age-sex categories were estimated using Poisson regression (adjusting for socioeconomic status, ethnicity, co-occurring conditions, stroke subtype and severity, and living conditions). Results Compared to men<55 years, women≥75 had higher prevalence for severe disability (BI<15) at all timepoints, e.g. PR4.13 (95% CI 2.93-5.81) at 1-year and PR3.33 (2.23-4.99) at 5-years, and higher than males≥75years. Both men and women ≥75years had similarly higher prevalence for inactivity (FAI score≤15) at all timepoints, e.g., men≥75years:PR1.91 (1.50-2.44), women≥75years:PR2.1 (1.66-2.62). Further, individuals aged 55-74 and ≥75 years had significantly and similarly higher prevalencce for worse cognition at all timepoints compared to men aged <55years with no sex differences. However, both men and women ≥75years had lower prevalence for anxiety/depression (HADS score≥8) at all time points compared to men <55years, e.g., for anxiety PR0.34 (0.19-0.60) for men and PR0.28 (0.15-0.53) for women ≥75years. Conclusions Older women have worse disability compared to males 5-years post-stroke, with limited evidence for sex differences in other outcomes Conflict of interest Amal R. Khanolkar: nothing to disclose, Ajay Bhalla: nothing to disclose, Eva Emmett: nothing to disclose, Camila Pantoja-Ruiz: nothing to disclose, Charles DA Wolfe: nothing to disclose, Matthew DL O’Connell: nothing to disclose, Iain J Marshall: nothing to disclose