Stroke Patients Fare Better with Good Neighbors

Your odds of surviving a stroke may depend on just how friendly your neighbors are, a new study suggests.

The results show older adults who have suffered a stroke have a much better chance of survival if they live in neighborhoods where they interact more often with their neighbors and can count on them for help.

"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 ," said study researcher Cari Jo Clark, assistant professor of medicine at the University of Minnesota in Minneapolis. "What is unique about our research is that we have taken this to the neighborhood level instead of just looking at the individual."

However, the researchers note, the benefit of friendly neighborhoods for stroke survival was only observed among whites; further research is needed to examine why this might be the case.

The study will be published in the May issue of Stroke: Journal of the American Heart Association.

Stroke survival

Clark and colleagues studied 5,789 seniors (average age of 75) living in three adjacent neighborhoods in Chicago. Researchers interviewed the subjects about their neighborhood and their interactions with neighbors. They identified 186 stroke deaths and 701 first strokes over 11 years of follow-up. In their analysis, they accounted for other factors that might negatively affect stroke survival, including high blood pressure , smoking, physical inactivity, diabetes and obesity.

The researchers asked subjects several question to measure the neighbor's "cohesiveness." These included: "Do you see neighbors and friends talking outside in the yard or on the street?" "Do you see neighbors watching out for each other, such as calling if they see a problem?" and how many neighbors "could you call on for assistance in doing something around your home or yard or 'borrow a cup of sugar' or ask some other small favor?"For each single point increase in the neighborhood "cohesion" scoring system, survival increased 53 percent.

While stroke incidence didn't differ among neighborhoods, stroke survival was far better for seniors living in "cohesive" neighborhoods, regardless of their gender. However, the benefit was not observed among African-American subjects.

Friendly neighborhoods

The finding "underscores the positive aspects of close neighbors and neighborhoods, and should help bolster efforts to improve such cohesiveness," Clark said.

One possible reason for improved survival is that seniors living in closer neighborhoods have others looking out for them who can get help sooner if they start experiencing stroke symptoms. They're also less mobile, and neighborhood conditions may be especially relevant.

Why seniors in African-American neighborhoods didn't fare as well is unclear and further research is needed, 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."

Pass it on: Older adults who have suffered a stroke have a better chance of survival if they live in cohesive neighborhoods.

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