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Stroke. 2014 Oct;45(10):2868-73. doi: 10.1161/STROKEAHA.114.005815. Epub 2014 Aug 19.

Social network, social support, and risk of incident stroke: Atherosclerosis Risk in Communities study.

Author information

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.

KEYWORDS:

epidemiology; inflammation; social support; stroke

PMID:
25139878
PMCID:
PMC4201236
DOI:
10.1161/STROKEAHA.114.005815
[Indexed for MEDLINE]
Free PMC Article

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