Faculty Collaboration Database

Understanding the relationship between social risk factors and functional limitation among stroke survivors in the US. J Stroke Cerebrovasc Dis 2024 Apr;33(4):107583

Date

01/20/2024

Pubmed ID

38242184

Pubmed Central ID

PMC10939811

DOI

10.1016/j.jstrokecerebrovasdis.2024.107583

Scopus ID

2-s2.0-85186741833 (requires institutional sign-in at Scopus site)

Abstract

BACKGROUND: Stroke is the fifth leading cause of death and disability in the United States. Social risk factors contribute to recovery from stroke, however the relationship between social risk factors and functional limitation among stroke survivors remains unknown.

METHODS: Data on 2,888 adults with stroke from the National Health Interview Survey from 2016-2018 was analyzed. The primary independent variables included six social risk factors: economic instability, lack of community, educational deficit, food insecurity, social isolation, and inadequate access to care. The outcome measure was functional limitation count. Negative binomial regression models were run to test the relationship between the independent and dependent variables adjusting for covariates.

RESULTS: Overall, 56% of the study participants were aged 65+, 70% were Non-Hispanic White, and 95% had at least one comorbidity. The mean functional limitation count was 1.8. In the unadjusted model, each social risk factor was significantly associated with functional limitation. In the fully adjusted model, significant association with functional limitation was found in individuals reporting economic instability (Incidence rate ratio [IRR] 1.65, 95% CI 1.33, 2.06), food insecurity (IRR 1.28, 95% CI 1.15, 1.42), and social isolation (IRR 1.64, 95% CI 1.48, 1.82).

CONCLUSIONS: Social risk factors such as economic instability, food insecurity and social isolation are significantly associated with functional limitation in adults with stroke. Interventions designed to address both social and medical needs have the potential to improve physical functioning and other clinical outcomes in stroke survivors.

Author List

Terrell J, Campbell JA, Thorgerson A, Bhandari S, Egede LE

Authors

Sanjay Bhandari MD Assistant Professor in the Medicine department at Medical College of Wisconsin
Jennifer Annette Campbell PhD, MPH Assistant Professor in the Medicine department at Medical College of Wisconsin
Leonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Comorbidity
Humans
Risk Factors
Stroke
Surveys and Questionnaires
Survivors
United States