The prevalence of poststroke cognitive impairment and dementia (PSCID) varies widely, depending on the outcome definition, timepoint(s) and frequency of assessments, type of study, length of follow up, and demographics and geographic region of the population. Nonetheless, it is widely recognized that PSCID is associated with disability, dependency, and morbidity. Thus, it is a critical public health topic relevant to stroke survivors, caregivers, and healthcare providers. Most studies of PSCID adjust for sex as a covariate, because “it is known to be associated with cognitive impairment following stroke.” It is estimated that approximately 55,000 more females than males have a stroke each year in the US, partially attributable to women tending to live longer than men. However, in recent years the decline in stroke incidence has stalled and in younger ages (< 45), it may be increasing at a faster rate in women than men. This session will compare and contrast the evidence related to sex differences in the prevalence and incidence of PSCID across a wide range of studies (Talk 1) and further examine what is known and unknown about sex differences in the impact of pre-stroke and poststroke risk factors in PSCID (e.g., age, race, education, diabetes, hypertension, smoking, physical activity, atrial fibrillation, stroke characteristics, etc.) (Talk 2). The role of immunity in post-stroke cognitive decline, i.e., susceptibility to increased levels of cortisol associated with stress, role of other hormonal factors and immune cells will be in 3^rd talk, including translational science (Talk 3). The fourth presentation will focus on sex- and gender considerations to manage risk factors to reduce cognitive decline post stroke. It is well documented that women and men have different physiological adaptations to exercise. Evidence from both animal and human studies will be presented related to sex and gender differences in the efficacy of exercise and other factors to prevent cognitive decline poststroke (Talk 4). Finally, a discussant will summarize what is known and gaps in knowledge, and will focus on information to guide poststroke care and development of clinical trials to prevent or slow PSCID (Talk 5).

Guido Falcone

YALE UNIVERSITY SCHOOL OF MEDICINE

Appearances