Elderly people who live in supportive neighborhoods have a considerably better chance of surviving a stroke than other seniors, researchers from the University of Minnesota and Rush University wrote in the journal Stroke. However, the authors added that having good neighbors does not appear to have any impact on your chances of having a stroke.
A stroke is when blood flow to an area of the brain is interrupted, either because of a blood clot or a ruptured artery or blood vessel. If brain cells are deprived of essential oxygen and glucose they die, resulting in brain damage. Stroke survivors may have problems with speech, movement and memory. Ischemic stroke accounts for 75% of all strokes – they are caused by blood clots. Hemorrhagic strokes occur when a blood vessel on the brain’s surface ruptures, the space between the brain and skull fills with blood; hemorrhagic strokes may also occur when a defective artery in the brain bursts and fills the surrounding tissue with blood.
Lead author, Cari Jo Clark, Sc.D., said:
“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. What is unique about our research is that we have taken this to the neighborhood level instead of just looking at the individual.”
Clark monitored 5,789 elderly individuals in three adjacent neighborhoods in Chicago. 60% of them were women, 62% African-American, and their average age was 75 years. Each was interviewed regarding where they lived and what kind of relationship they had with their neighbors. 186 stroke deaths and 701 first strokes over an 11-year follow-up period were identified using the National Death Index and Medicare claim files.
The researchers took into account several risk factors linked to stroke in their analysis, including hypertension (high blood pressure), smoking status, obesity, sedentary lifestyle, diabetes and socioeconomic status.
Cohesiveness questions were used to assess how closely-knit neighborhoods were. The participants were asked:
- Whether they saw friends and neighbors talking outside on the street or in the yard?
- Whether they witnessed neighbors taking care of one another, such as babysitting or helping out with gardening
- Did they see their neighbors keeping an eye on each other, such as calling if a problem was suspected?
- Whether they were on name-terms with their neighbors
- Whether they had a friendly chat at least weekly with their neighbors
- Whether they could ask a neighbor for help with, for example helping out in the yard or home, borrowing a cup of sugar, or asking for a small favor
The researchers found that stroke survival increased by 53% for each single point increase in the neighborhood cohesion scoring system.
Even though the risk of having a stroke remained unchanged, regardless of how closely knit neighborhoods were, the authors found that the chances of surviving a stroke were significantly greater in cohesive neighborhoods. Better stroke survival was found among males and females.
Better stroke survival in friendly neighborhoods was only observed among Caucasian seniors (white elderly people).
Clark said:
“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. Nonetheless, it underscores the positive aspects of close neighbors and neighborhoods, and should help bolster efforts to improve such cohesiveness.”
The authors believe that the main factor that helps stroke survival in close-knit neighborhoods is access to prompt professional help – if people are looking out for each other, stroke victims are much more likely to get help sooner. An individual’s chances of surviving a stroke are considerably increased if they are treated promptly.
The authors could not explain why this benefit was not observed among elderly individuals in African-American neighborhoods.
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.”
Cari Jo Clark, ScD; Hongfei Guo, PhD; Scott Lunos, MS; Neelum T. Aggarwal, MD; Todd Beck, MS; Denis A. Evans, MD; Carlos Mendes de Leon, PhD; Susan A. Everson-Rose, PhD
Stroke April 14, 2011, doi: 10.1161/STROKEAHA.110.609164
Written by Christian Nordqvist