The role of social resources and trajectories of functional health following stroke

Takeshi Nakagawa; Taiji Noguchi; Ayane Komatsu; Tami Saito

doi:10.1016/j.socscimed.2022.115322

The role of social resources and trajectories of functional health following stroke

Soc Sci Med. 2022 Oct:311:115322. doi: 10.1016/j.socscimed.2022.115322. Epub 2022 Aug 30.

Authors

Takeshi Nakagawa¹, Taiji Noguchi², Ayane Komatsu³, Tami Saito⁴

Affiliations

¹ Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan. Electronic address: ntakeshi@ncgg.go.jp.
² Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan. Electronic address: noguchi@ncgg.go.jp.
³ Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan. Electronic address: ayane-k@ncgg.go.jp.
⁴ Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obu, Aichi, 474-8511, Japan. Electronic address: t-saito@ncgg.go.jp.

PMID: 36067620
DOI: 10.1016/j.socscimed.2022.115322

Abstract

Stroke is a major cause of disability in old age. Research has revealed that social resources available after the onset of stroke can mitigate functional prognosis. However, most studies have conceptualized resources as static rather than dynamic and have not measured changes in social resources from the pre-to post-stroke periods. To better understand the recovery process following stroke, we examined how social resources available before its onset and changes from pre-to post-stroke were associated with trajectories of functional health following stroke. Data were derived from an up to 19-year longitudinal study of a nationally representative sample of Japanese adults aged 60 years and older. We identified 389 people who experienced self- or proxy-reported first stroke during follow-up (age at stroke onset: M = 75.9, SD = 6.8; 49.1% women). The average number of observations was 4.6 (SD = 1.6, range 2-7). Functional health was measured with self- or proxy-reported basic and instrumental activities of daily living. Social resources were indexed as residential status, contact with own non-coresident children, social participation, and perceived support. Analyses were adjusted for age at stroke onset, sex, education, health condition, and cognitive function. A multiphase growth model indicated that individuals who participated more frequently in social groups prior to stroke exhibited less functional deterioration post-stroke than those who participated less frequently. Whereas contact frequency with non-coresident children typically declined following stroke, the analysis further revealed that individuals who maintained contact frequency from pre-to post-stroke showed less steep functional decline over time in the post-stroke period despite minor individual differences. We found that social resources before stroke onset and changes in the resources following stroke may play a protective role against adverse prognoses. Inclusive communities may help older adults remain independent even after serious health events.

Keywords: Disability; Functional limitations; Longitudinal, Older adults; Prognosis; Social network; Social participation; Social support.