Social readjustment and ischemic stroke: Lack of an association in a multiethnic population
Gregory A. Abel, Xun Chen, Bernadette Boden-Albala, Ralph L Sacco, Ralph L. Sacco
Clinical experience has suggested that stressful life events and ongoing stressful illness, collectively termed 'social readjustment', may precipitate stroke. We investigated the association between a simple in-office evaluation of such stressors and stroke in an urban, multiethnic study population. Cases were patients from the Northern Manhattan Stroke Study with first ischemic stroke; controls were derived through random digit dialing with n:m matching for age, gender, and race-ethnicity. Social readjustment was measured through in-person interview using Amster and Krauss' Geriatric Social Readjustment Rating Scale (GSRRS), a one-time, 35-item, checklist type weighted questionnaire of stressful life events occurring in the previous 6 months. Conditional logistic regression was used to analyze the GSRRS and its quartiles as well as stressful events subgroups, adjusting for education, hypertension, cardiac disease, diabetes, and number of weekly visits as a measure of socialization. Six hundred and fifty-five cases of ischemic stroke and 1,087 controls were utilized. The mean age of the cases was 69.8 years, with 55.4% women, 51.0% Hispanics, 28.4% blacks, and 19.1% whites. GSRRS scores ranged from 0 to 812; the mean score was 205.5 for the cases and 206.2 for the controls. The analysis showed no association between stroke and a 20- point increase on the GSRRS (OR=1.01,95% CI=0.99-1.01). There was also no effect for the second, third or highest versus lowest quartile. No association was found in age, gender or race-ethnic subgroups, or when analyzing negative events, severely threatening events, or ongoing stressful illnesses separately. While this study does not preclude social readjustment as a stroke risk factor, it suggests that the one-time assessment often done in the medical office setting has little relevance for stroke prevention planning.
Neuroepidemiology
Social readjustment
Abel, G. A., Chen, X., Boden-Albala, B., Sacco, R. L., & Sacco, R. L. (1999). Social readjustment and ischemic stroke: Lack of an association in a multiethnic population. Neuroepidemiology, 18(1), 22-31. https://doi.org/10.1159/000026192
Social readjustment and ischemic stroke : Lack of an association in a multiethnic population. / Abel, Gregory A.; Chen, Xun; Boden-Albala, Bernadette; Sacco, Ralph L; Sacco, Ralph L.
In: Neuroepidemiology, Vol. 18, No. 1, 01.01.1999, p. 22-31.
Abel, GA, Chen, X, Boden-Albala, B, Sacco, RL & Sacco, RL 1999, 'Social readjustment and ischemic stroke: Lack of an association in a multiethnic population', Neuroepidemiology, vol. 18, no. 1, pp. 22-31. https://doi.org/10.1159/000026192
Abel GA, Chen X, Boden-Albala B, Sacco RL, Sacco RL. Social readjustment and ischemic stroke: Lack of an association in a multiethnic population. Neuroepidemiology. 1999 Jan 1;18(1):22-31. https://doi.org/10.1159/000026192
Abel, Gregory A. ; Chen, Xun ; Boden-Albala, Bernadette ; Sacco, Ralph L ; Sacco, Ralph L. / Social readjustment and ischemic stroke : Lack of an association in a multiethnic population. In: Neuroepidemiology. 1999 ; Vol. 18, No. 1. pp. 22-31.
@article{5ede0229436f403980a529a9aec0451e,
title = "Social readjustment and ischemic stroke: Lack of an association in a multiethnic population",
abstract = "Clinical experience has suggested that stressful life events and ongoing stressful illness, collectively termed 'social readjustment', may precipitate stroke. We investigated the association between a simple in-office evaluation of such stressors and stroke in an urban, multiethnic study population. Cases were patients from the Northern Manhattan Stroke Study with first ischemic stroke; controls were derived through random digit dialing with n:m matching for age, gender, and race-ethnicity. Social readjustment was measured through in-person interview using Amster and Krauss' Geriatric Social Readjustment Rating Scale (GSRRS), a one-time, 35-item, checklist type weighted questionnaire of stressful life events occurring in the previous 6 months. Conditional logistic regression was used to analyze the GSRRS and its quartiles as well as stressful events subgroups, adjusting for education, hypertension, cardiac disease, diabetes, and number of weekly visits as a measure of socialization. Six hundred and fifty-five cases of ischemic stroke and 1,087 controls were utilized. The mean age of the cases was 69.8 years, with 55.4{\%} women, 51.0{\%} Hispanics, 28.4{\%} blacks, and 19.1{\%} whites. GSRRS scores ranged from 0 to 812; the mean score was 205.5 for the cases and 206.2 for the controls. The analysis showed no association between stroke and a 20- point increase on the GSRRS (OR=1.01,95{\%} CI=0.99-1.01). There was also no effect for the second, third or highest versus lowest quartile. No association was found in age, gender or race-ethnic subgroups, or when analyzing negative events, severely threatening events, or ongoing stressful illnesses separately. While this study does not preclude social readjustment as a stroke risk factor, it suggests that the one-time assessment often done in the medical office setting has little relevance for stroke prevention planning.",
keywords = "Cerebrovascular disease, Epidemiology, Life events, Social readjustment, Stress, Stroke",
author = "Abel, {Gregory A.} and Xun Chen and Bernadette Boden-Albala and Sacco, {Ralph L} and Sacco, {Ralph L.}",
journal = "Neuroepidemiology",
T1 - Social readjustment and ischemic stroke
T2 - Lack of an association in a multiethnic population
AU - Abel, Gregory A.
AU - Chen, Xun
AU - Boden-Albala, Bernadette
AU - Sacco, Ralph L
AU - Sacco, Ralph L.
N2 - Clinical experience has suggested that stressful life events and ongoing stressful illness, collectively termed 'social readjustment', may precipitate stroke. We investigated the association between a simple in-office evaluation of such stressors and stroke in an urban, multiethnic study population. Cases were patients from the Northern Manhattan Stroke Study with first ischemic stroke; controls were derived through random digit dialing with n:m matching for age, gender, and race-ethnicity. Social readjustment was measured through in-person interview using Amster and Krauss' Geriatric Social Readjustment Rating Scale (GSRRS), a one-time, 35-item, checklist type weighted questionnaire of stressful life events occurring in the previous 6 months. Conditional logistic regression was used to analyze the GSRRS and its quartiles as well as stressful events subgroups, adjusting for education, hypertension, cardiac disease, diabetes, and number of weekly visits as a measure of socialization. Six hundred and fifty-five cases of ischemic stroke and 1,087 controls were utilized. The mean age of the cases was 69.8 years, with 55.4% women, 51.0% Hispanics, 28.4% blacks, and 19.1% whites. GSRRS scores ranged from 0 to 812; the mean score was 205.5 for the cases and 206.2 for the controls. The analysis showed no association between stroke and a 20- point increase on the GSRRS (OR=1.01,95% CI=0.99-1.01). There was also no effect for the second, third or highest versus lowest quartile. No association was found in age, gender or race-ethnic subgroups, or when analyzing negative events, severely threatening events, or ongoing stressful illnesses separately. While this study does not preclude social readjustment as a stroke risk factor, it suggests that the one-time assessment often done in the medical office setting has little relevance for stroke prevention planning.
AB - Clinical experience has suggested that stressful life events and ongoing stressful illness, collectively termed 'social readjustment', may precipitate stroke. We investigated the association between a simple in-office evaluation of such stressors and stroke in an urban, multiethnic study population. Cases were patients from the Northern Manhattan Stroke Study with first ischemic stroke; controls were derived through random digit dialing with n:m matching for age, gender, and race-ethnicity. Social readjustment was measured through in-person interview using Amster and Krauss' Geriatric Social Readjustment Rating Scale (GSRRS), a one-time, 35-item, checklist type weighted questionnaire of stressful life events occurring in the previous 6 months. Conditional logistic regression was used to analyze the GSRRS and its quartiles as well as stressful events subgroups, adjusting for education, hypertension, cardiac disease, diabetes, and number of weekly visits as a measure of socialization. Six hundred and fifty-five cases of ischemic stroke and 1,087 controls were utilized. The mean age of the cases was 69.8 years, with 55.4% women, 51.0% Hispanics, 28.4% blacks, and 19.1% whites. GSRRS scores ranged from 0 to 812; the mean score was 205.5 for the cases and 206.2 for the controls. The analysis showed no association between stroke and a 20- point increase on the GSRRS (OR=1.01,95% CI=0.99-1.01). There was also no effect for the second, third or highest versus lowest quartile. No association was found in age, gender or race-ethnic subgroups, or when analyzing negative events, severely threatening events, or ongoing stressful illnesses separately. While this study does not preclude social readjustment as a stroke risk factor, it suggests that the one-time assessment often done in the medical office setting has little relevance for stroke prevention planning.
KW - Cerebrovascular disease
KW - Life events
KW - Social readjustment
KW - Stress
JO - Neuroepidemiology
JF - Neuroepidemiology