Senior Citizens Have Better Chance of Surviving a
Stroke Living in Sociable Neighborhoods
Seniors living in closely-knit, supportive
neighborhoods have significantly better stroke survival rates,
regardless of other health, socioeconomic factors
April 14, 2011 - The odds of
surviving stroke appear to be much better for seniors living in
neighborhoods where they interact more often with their neighbors and
count on them for help, according to research published in Stroke:
Journal of the American Heart Association.
"Social isolation is unhealthy
on many levels, and there is a lot of literature showing that increased
social support improves not just stroke, but many other health outcomes
in seniors," said Cari Jo Clark, Sc.D., lead author of the study and
assistant professor of medicine at the University of Minnesota in
Minneapolis.
"What is unique about our
research is that we have taken this to the neighborhood level instead of
just looking at the individual."
Clark and colleagues at the
University of Minnesota and Rush University in Chicago studied 5,789
seniors (60 percent women, 62 percent black, average age 75) living in
three adjacent neighborhoods in Chicago. Researchers interviewed the
participants about their neighborhood and their interactions with
neighbors.
Using the National Death Index
and Medicare claim files, they identified 186 stroke deaths and 701
first strokes over 11 years of follow-up. In their analysis, they
factored out potential contributing variables such as socioeconomic
status and cardiovascular risk factors like high blood pressure,
smoking, physical inactivity, diabetes and obesity.
Learn to Recognize a Stroke
and What to Do
● Sudden numbness or
weakness of the face, arm or leg, especially on one side of the body
● Sudden confusion,
trouble speaking or understanding
● Sudden trouble
seeing in one or both eyes
● Sudden trouble
walking, dizziness, loss of balance or coordination
● Sudden, severe
headache with no known cause
Immediately call 9-1-1 or the
emergency medical services (EMS) number so an ambulance (ideally with
advanced life support) can be sent for you.
Also, check the time so you'll
know when the first symptoms appeared. It's very important to take
immediate action. If given within 3 hours of the start of symptoms, a
clot-busting drug called tissue plasminogen activator (tPA) may reduce
long-term disability for the most common type of stroke.
tPA is the only FDA-approved
medication for the treatment of stroke within three hours of stroke
symptom onset.
A TIA or
transient ischemic attack is a "warning stroke" or "mini-stroke" that
produces stroke-like symptoms but no lasting damage. Recognizing and
treating TIAs can reduce your risk of a major stroke.
The usual TIA symptoms are the
same as those of stroke, only temporary. The short duration of these
symptoms and lack of permanent brain injury is the main difference
between TIA and stroke.
The researchers used questions
measuring "cohesiveness." They asked how often (often, sometimes, rarely
or never) the following occurred in each neighborhood:
● Do you see neighbors and
friends talking outside in the yard or on the street?
● Do you see neighbors
taking care of each other, such as doing yard work or watching children?
● Do you see neighbors
watching out for each other, such as calling if they see a problem?
They were also asked how many
neighbors...
● Do you know by name?
● Do you have a friendly
talk with at least once a week?
● Could you call on for
assistance in doing something around your home or yard or "borrow a cup
of sugar" or ask some other small favor?
For each single point increase
in the neighborhood "cohesion" scoring system, survival increased 53
percent.
While stroke incidence didn't
differ among neighborhoods, stroke survival was far better for seniors
living in "cohesive" neighborhoods, regardless of their gender. However,
the benefit was only observed among whites.
"I think this indicates that a
positive neighborhood social environment is as important to senior
health as stress or even crime, but it is a really complex issue," Clark
said. "Nonetheless, it underscores the positive aspects of close
neighbors and neighborhoods, and should help bolster efforts to improve
such cohesiveness."
One possible reason for
improved survival is that seniors living in closer neighborhoods have
others looking out for them who can get help sooner if they start
experiencing stroke symptoms.
They're also less mobile, and neighborhood
conditions may be especially relevant. Recent longitudinal research has
also found a significant protective relationship between social support
and stroke mortality, but not stroke incidence.
Why seniors in
African-American neighborhoods didn't fare as well is unclear and
further research is needed, Clark said. "Obviously, a complex set of
factors influences health in older adults and we need to be careful
drawing conclusions from these data. Other research also has shown that
the health protective effects of cohesive neighborhoods may be stronger
in whites. We plan to conduct future studies to try to understand these
findings."
Co-authors are Susan A.
Everson-Rose, Ph.D.; Hongfei Guo, Ph.D.; Scott Lunos, M.S.; Neelum T.
Aggarwal, M.D.; Todd Beck, M.S.; Denis A. Evans, M.D.; and Carlos Mendes
de Leon, Ph.D. Author disclosures are on the manuscript.
The study was funded by the
National Institutes of Health and the University of Minnesota.
April 14, 2011 - The odds of
surviving stroke appear to be much better for seniors living in
neighborhoods where they interact more often with their neighbors and
count on them for help, according to research published in Stroke:
Journal of the American Heart Association.
