Dataset Information

Exploring psychosocial pathways between neighbourhood characteristics and stroke in older adults: the cardiovascular health study.

ABSTRACT:

Objectives

to investigate whether psychosocial pathways mediate the association between neighbourhood socioeconomic disadvantage and stroke.

Methods

prospective cohort study with a follow-up of 11.5 years.

Setting

the Cardiovascular Health Study, a longitudinal population-based cohort study of older adults ?65 years.

Measurements

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.

Results

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.

Conclusions

psychosocial factors played a minimal role in mediating the effect of NSES on stroke incidence among white older adults.

SUBMITTER: Yan T

PROVIDER: S-EPMC3633364 | biostudies-literature | 2013 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Exploring psychosocial pathways between neighbourhood characteristics and stroke in older adults: the cardiovascular health study.

Yan Tingjian T Escarce José J JJ Liang Li-Jung LJ Longstreth W T WT Merkin Sharon Stein SS Ovbiagele Bruce B Vassar Stefanie D SD Seeman Teresa T Sarkisian Catherine C Brown Arleen F AF

Age and ageing 20121221 3

<h4>Objectives</h4>to investigate whether psychosocial pathways mediate the association between neighbourhood socioeconomic disadvantage and stroke.<h4>Methods</h4>prospective cohort study with a follow-up of 11.5 years.<h4>Setting</h4>the Cardiovascular Health Study, a longitudinal population-based cohort study of older adults ≥65 years.<h4>Measurements</h4>the primary outcome was adjudicated incident ischaemic stroke. Neighbourhood socioeconomic status (NSES) was measured using a composite of ...[more]

PMID: 23264005

Similar Datasets

Project description:BackgroundResearch implicates acute and chronic stressors in racial/ethnic health disparities, but the joint impact of multiple stressors on racial/ethnic disparities in cardiovascular health is unknown.MethodsIn 25 062 women (24 053 white; 256 Hispanic; 440 black; 313 Asian) articipating in the Women's Health Study follow-up cohort, we examined the relationship between cumulative psychosocial stress (CPS) and ideal cardiovascular health (ICH), as defined by the American Heart Association's 2020 strategic Impact Goals. This health metric includes smoking, body mass index, physical activity, diet, blood pressure, total cholesterol, and glucose, with higher levels indicating more ICH and less cardiovascular risk (score range, 0-7). We created a CPS score that summarized acute stressors (eg, negative life events) and chronic stressors (eg, work, work-family spillover, financial, discrimination, relationship, and neighborhood) and traumatic life event stress reported on a stress questionnaire administered in 2012 to 2013 (score range, 16-385, with higher scores indicating higher levels of stress).ResultsWhite women had the lowest mean CPS scores (white: 161.7±50.4; Hispanic: 171.2±51.7; black: 172.5±54.9; Asian: 170.8±50.6; Poverall<0.01). Mean CPS scores remained higher in Hispanic, black, and Asian women than in white women after adjustment for age, socioeconomic status (income and education), and psychological status (depression and anxiety) ( P<0.01 for each). Mean ICH scores varied by race/ethnicity ( P<0.01) and were significantly lower in black women and higher in Asian women compared with white women (β-coefficient [95% CI]: Hispanics, -0.02 [-0.13 to -0.09]; blacks, -0.34 [-0.43 to -0.25]; Asians, 0.34 [0.24 to 0.45]); control for socioeconomic status and CPS did not change these results. Interactions between CPS and race/ethnicity in ICH models were not significant.ConclusionsBoth CPS and ICH varied by race/ethnicity. ICH remained worse in blacks and better in Asians compared with whites, despite taking into account socioeconomic factors and CPS.

Dataset Information

Exploring psychosocial pathways between neighbourhood characteristics and stroke in older adults: the cardiovascular health study.

Objectives

Methods

Setting

Measurements

Results

Conclusions

Publications

Exploring psychosocial pathways between neighbourhood characteristics and stroke in older adults: the cardiovascular health study.

Similar Datasets

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