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Exploring psychosocial pathways between neighbourhood characteristics and stroke in older adults: the cardiovascular health study.
Monday,2013-04-22 14:28 America/Los_Angeles — eenright
| Title | Exploring psychosocial pathways between neighbourhood characteristics and stroke in older adults: the cardiovascular health study. |
| Publication Type | Journal Article |
| Year of Publication | 2013 |
| Authors | Yan, T, Escarce, JJ, Liang, L-J, Longstreth, WT, Merkin, SStein, Ovbiagele, B, Vassar, SD, Seeman, T, Sarkisian, C, Brown, AF |
| Journal | Age Ageing |
| Volume | 42 |
| Issue | 3 |
| Pagination | 391-7 |
| Date Published | 2013 May |
| ISSN | 1468-2834 |
| Keywords | African Americans, Age Factors, Aged, Aged, 80 and over, Aging, Brain Ischemia, Depression, European Continental Ancestry Group, Female, Follow-Up Studies, Humans, Incidence, Linear Models, Logistic Models, Male, Middle Aged, Proportional Hazards Models, Prospective Studies, Residence Characteristics, Risk Assessment, Risk Factors, Social Support, Socioeconomic Factors, Stroke, Time Factors, United States, Vulnerable Populations |
| Abstract | <p><b>OBJECTIVES: </b>to investigate whether psychosocial pathways mediate the association between neighbourhood socioeconomic disadvantage and stroke.</p><p><b>METHODS: </b>prospective cohort study with a follow-up of 11.5 years.</p><p><b>SETTING: </b>the Cardiovascular Health Study, a longitudinal population-based cohort study of older adults ≥65 years.</p><p><b>MEASUREMENTS: </b>the primary outcome was adjudicated incident ischaemic stroke. Neighbourhood socioeconomic status (NSES) was measured using a composite of six census-tract variables. Psychosocial factors were assessed with standard measures for depression, social support and social networks.</p><p><b>RESULTS: </b>of the 3,834 white participants with no prior stroke, 548 had an incident ischaemic stroke over the 11.5-year follow-up. Among whites, the incident stroke hazard ratio (HR) associated with living in the lowest relative to highest NSES quartile was 1.32 (95% CI = 1.01-1.73), in models adjusted for individual SES. Additional adjustment for psychosocial factors had a minimal effect on hazard of incident stroke (HR = 1.31, CI = 1.00-1.71). Associations between NSES and stroke incidence were not found among African-Americans (n = 785) in either partially or fully adjusted models.</p><p><b>CONCLUSIONS: </b>psychosocial factors played a minimal role in mediating the effect of NSES on stroke incidence among white older adults.</p> |
| DOI | 10.1093/ageing/afs179 |
| Alternate Journal | Age Ageing |
| PubMed ID | 23264005 |
| PubMed Central ID | PMC3633364 |
| Grant List | UL1TR000124 / TR / NCATS NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States UL1 TR000124 / TR / NCATS NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01-HC-35129 / HC / NHLBI NIH HHS / United States N01 HC-55222 / HC / NHLBI NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States N01 HC-15103 / HC / NHLBI NIH HHS / United States N01-HC-45133 / HC / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States N01-HC-85239 / HC / NHLBI NIH HHS / United States |