Social isolation and outcomes post stroke

Bernadette Boden-Albala, E. Litwak, M. S V Elkind, Tatjana Rundek, Ralph L Sacco

Research output: Contribution to journalArticle

158 Citations (Scopus)

Abstract

Objective: To assess the relationship between social isolation and stroke outcomes in a multiethnic cohort. Methods: As part of the Northern Manhattan Stroke Study, the authors prospectively followed a cohort of patients with stroke for 5 years. Baseline data including social isolation were collected. At follow-up, the authors documented outcome events as defined by the first occurrence of myocardial infarction (MI), stroke recurrence, or death. Cox hazard models were used to calculate the hazard ratio (HR, 95% CI) for prestroke predictors of post stroke outcomes. Results: The authors followed 655 ischemic stroke cases for a mean of 5 years. The cohort was 55% women; 17% white, 27% African American, 54% Hispanic; mean age 69 ± 12 years. There were 265 first outcome events. In univariate analysis, coronary artery disease (OR 1.3, 1.0 to 1.7), age > 70 years (OR 1.9, 1.5 to 2.5), atrial fibrillation (AF) (OR 1.8, 1.3 to 2.5), race-ethnicity (white vs Hispanic) (OR 1.7, 1.1 to 2.9), physical inactivity (OR 1.3, 1.1 to 2.6), help at home (OR 1.8, 1.4 to 2.4), and social isolation (OR 1.4, 1.2 to 1.6) were associated with increased risk of an outcome event. No association was seen for hypertension, diabetes, education, sex, insurance, occupation, marital status, or primary care physician. In the multivariable model controlling for age, AF (OR 1.9, 1.5 to 2.5), help at home (OR 1.5, 1.1 to 2.0), and social isolation (OR 1.4, 1.1 to 1.8) predicted outcome events. Conclusion: Prestroke social isolation is a predictor of outcome events post stroke. Lack of social support may contribute to poorer outcomes due to poor compliance, depression, and stress.

Original languageEnglish
Pages (from-to)1888-1892
Number of pages5
JournalNeurology
Volume64
Issue number11
DOIs
StatePublished - Jun 14 2005
Externally publishedYes

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Social Isolation
Stroke
Hispanic Americans
Proportional Hazards Models
Atrial Fibrillation
Sex Education
Marital Status
Primary Care Physicians
Insurance
Occupations
Social Support
African Americans
Coronary Artery Disease
Myocardial Infarction
Depression
Hypertension
Recurrence

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Social isolation and outcomes post stroke. / Boden-Albala, Bernadette; Litwak, E.; Elkind, M. S V; Rundek, Tatjana; Sacco, Ralph L.

In: Neurology, Vol. 64, No. 11, 14.06.2005, p. 1888-1892.

Research output: Contribution to journalArticle

Boden-Albala, B, Litwak, E, Elkind, MSV, Rundek, T & Sacco, RL 2005, 'Social isolation and outcomes post stroke', Neurology, vol. 64, no. 11, pp. 1888-1892. https://doi.org/10.1212/01.WNL.0000163510.79351.AF
Boden-Albala, Bernadette ; Litwak, E. ; Elkind, M. S V ; Rundek, Tatjana ; Sacco, Ralph L. / Social isolation and outcomes post stroke. In: Neurology. 2005 ; Vol. 64, No. 11. pp. 1888-1892.
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