| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Departments of Neurology (Drs. Boden-Albala, Elkind, Rundek, and Sacco) and Sociomedical Science (Drs. Boden-Albala and Litwak), Sergievsky Center (Dr. Sacco), and Department of Epidemiology (Dr. Sacco), Columbia University College of Physicians and Surgeons and the Mailman School of Public Health, New York, NY.
Address correspondence and reprint requests to Dr. Bernadette Boden-Albala, Neurologic Institute, 710 West 168 Street, New York, NY 10032; e-mail: bb87{at}columbia.edu
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.
Received March 26, 2004. Accepted in final form March 3, 2005.
This article has been cited by other articles:
|
|
 |
|
  T. Rutledge, S. E. Linke, M. B. Olson, J. Francis, B. D. Johnson, V. Bittner, K. York, C. McClure, S. F. Kelsey, S. E. Reis, et al. Social Networks and Incident Stroke Among Women With Suspected Myocardial Ischemia Psychosom Med, April 1, 2008; 70(3): 282 - 287. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. E. Williams, M. I. Chimowitz, G. A. Cotsonis, M. J. Lynn, S. P. Waddy, and for the WASID Investigators Gender Differences in Outcomes Among Patients With Symptomatic Intracranial Arterial Stenosis Stroke, July 1, 2007; 38(7): 2055 - 2062. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Rundek Do Women Have Worse Outcome After Stroke Caused by Intracranial Arterial Stenosis? Stroke, July 1, 2007; 38(7): 2025 - 2027. [Full Text] [PDF]
|
|
|
|
|
|
M. L. Hackett, C. S. Anderson, and on behalf of the Auckland Regional Community Strok Frequency, Management, and Predictors of Abnormal Mood After Stroke: The Auckland Regional Community Stroke (ARCOS) Study, 2002 to 2003 Stroke, August 1, 2006; 37(8): 2123 - 2128. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Does Social Isolation Influence Outcomes After Stroke? Journal Watch Psychiatry, April 5, 2006; 2006(405): 9 - 9. [Full Text]
|
|
|
|
 |
|
 Does Social Isolation Influence Outcomes After Stroke? Journal Watch Neurology, February 23, 2006; 2006(223): 3 - 3. [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
