Mako Nagayoshi1, Susan A Everson-Rose2, Hiroyasu Iso2, Thomas H Mosley2, Kathryn M Rose2, Pamela L Lutsey2. 1. From the Division of Epidemiology and Community Health (M.N., P.L.L.) and Department of Medicine (S.A.E.-R.), University of Minnesota, Minneapolis; Department of Community Medicine, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan (M.N.); Department of Medicine, Osaka University, Suita, Japan (H.I.); Departments of Geriatrics/Gerontology and Neurology, University of Mississippi Medical Center, Jackson, MS (T.H.M.); and Department of Epidemiology, University of North Carolina at Chapel Hill (K.M.R.). mnagayoshi@nagasaki-u.ac.jp. 2. From the Division of Epidemiology and Community Health (M.N., P.L.L.) and Department of Medicine (S.A.E.-R.), University of Minnesota, Minneapolis; Department of Community Medicine, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan (M.N.); Department of Medicine, Osaka University, Suita, Japan (H.I.); Departments of Geriatrics/Gerontology and Neurology, University of Mississippi Medical Center, Jackson, MS (T.H.M.); and Department of Epidemiology, University of North Carolina at Chapel Hill (K.M.R.).
Abstract
BACKGROUND AND PURPOSE: Having a small social network and lack of social support have been associated with incident coronary heart disease; however, epidemiological evidence for incident stroke is limited. We assessed the longitudinal association of a small social network and lack of social support with risk of incident stroke and evaluated whether the association was partly mediated by vital exhaustion and inflammation. METHODS: The Atherosclerosis Risk in Communities study measured social network and social support in 13 686 men and women (mean, 57 years; 56% women; 24% black; 76% white) without a history of stroke. Social network was assessed by the 10-item Lubben Social Network Scale and social support by a 16-item Interpersonal Support Evaluation List-Short Form. RESULTS: During a median follow-up of 18.6 years, 905 incident strokes occurred. Relative to participants with a large social network, those with a small social network had a higher risk of stroke (hazard ratio [95% confidence interval], 1.44 [1.02-2.04]) after adjustment for demographics, socioeconomic variables, marital status, behavioral risk factors, and major stroke risk factors. Vital exhaustion, but not inflammation, partly mediated the association between a small social network and incident stroke. Social support was unrelated to incident stroke. CONCLUSIONS: In this sample of US community-dwelling men and women, having a small social network was associated with excess risk of incident stroke. As with other cardiovascular conditions, having a small social network may be associated with a modestly increased risk of incident stroke.
BACKGROUND AND PURPOSE: Having a small social network and lack of social support have been associated with incident coronary heart disease; however, epidemiological evidence for incident stroke is limited. We assessed the longitudinal association of a small social network and lack of social support with risk of incident stroke and evaluated whether the association was partly mediated by vital exhaustion and inflammation. METHODS: The Atherosclerosis Risk in Communities study measured social network and social support in 13 686 men and women (mean, 57 years; 56% women; 24% black; 76% white) without a history of stroke. Social network was assessed by the 10-item Lubben Social Network Scale and social support by a 16-item Interpersonal Support Evaluation List-Short Form. RESULTS: During a median follow-up of 18.6 years, 905 incident strokes occurred. Relative to participants with a large social network, those with a small social network had a higher risk of stroke (hazard ratio [95% confidence interval], 1.44 [1.02-2.04]) after adjustment for demographics, socioeconomic variables, marital status, behavioral risk factors, and major stroke risk factors. Vital exhaustion, but not inflammation, partly mediated the association between a small social network and incident stroke. Social support was unrelated to incident stroke. CONCLUSIONS: In this sample of US community-dwelling men and women, having a small social network was associated with excess risk of incident stroke. As with other cardiovascular conditions, having a small social network may be associated with a modestly increased risk of incident stroke.
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