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Author Notes:

Susan Everson-Rose, PhD, MPH, University of Minnesota, 717 Delaware Street SE, Suite 166, Minneapolis, MN 55414, Telephone: 612-626-6876, Fax: 612-626-6782, saer@umn.edu.

The authors thank all participants in the Chicago Health and Aging Project; as well as all administrative and field staff for community development, oversight of project coordination, study coordination and data collection.

Authors reported no disclosures.


Research Funding:

This work was supported by NIH grants, including grant HL084209 from the National Heart, Lung and Blood Institute (NHLBI); grant AG11101 from the National Institutes on Aging (NIA); and grant ES10902 from the National Institute on Environmental Health Sciences (NIEHS); grant K01HL092591 (Dr. Lewis) from NHLBI; grant 1KL2RR033182-01 (Dr. Clark) from the National Center For Research Resources (NCRR); grant 8UL1TR000114-02 from the National Center for Advancing Translational Sciences (NCATS); and by grant UL1RR033183 from NCRR to the University of Minnesota Clinical and Translational Science Institute (CTSI).

Dr. Everson-Rose also supported in part by grant 1P60MD003422 from the National Institute on Minority Health and Health Disparities (NIMHD).

Additional support provided by the Program in Health Disparities Research and the Applied Clinical Research Program (Dr. Clark; Dr. Everson-Rose; Mrs. Henderson) at the University of Minnesota.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Clinical Neurology
  • Peripheral Vascular Disease
  • Neurosciences & Neurology
  • Cardiovascular System & Cardiology
  • epidemiology
  • psychosocial stress
  • risk factors
  • women and minorities

Psychosocial Distress and Stroke Risk in Older Adults

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Journal Title:



Volume 44, Number 2


, Pages 367-372

Type of Work:

Article | Post-print: After Peer Review


BACKGROUND AND PURPOSE - : To investigate the association of psychosocial distress with risk of stroke mortality and incident stroke in older adults. METHODS - : Data were from the Chicago Health and Aging Project, a longitudinal population-based study conducted in 3 contiguous neighborhoods on the south side of Chicago, IL. Participants were community-dwelling black and non-Hispanic white adults, aged 65 years and older (n=4120 for stroke mortality; n=2649 for incident stroke). Psychosocial distress was an analytically derived composite measure of depressive symptoms, perceived stress, neuroticism, and life dissatisfaction. Cox proportional hazards models examined the association of distress with stroke mortality and incident stroke over 6 years of follow-up. RESULTS - : Stroke deaths (151) and 452 incident strokes were identified. Adjusting for age, race, and sex, the hazard ratio (HR) for each 1-SD increase in distress was 1.47 (95% confidence interval [CI]=1.28-1.70) for stroke mortality and 1.18 (95% CI=1.07-1.30) for incident stroke. Associations were reduced after adjustment for stroke risk factors and remained significant for stroke mortality (HR=1.29; 95% CI=1.10-1.52) but not for incident stroke (HR=1.09; 95% CI=0.98-1.21). Secondary analyses of stroke subtypes showed that distress was strongly related to incident hemorrhagic strokes (HR=1.70; 95% CI=1.28-2.25) but not ischemic strokes (HR=1.02; 95% CI=0.91-1.15) in fully adjusted models. CONCLUSIONS - : Increasing levels of psychosocial distress are related to excess risk of both fatal and nonfatal stroke in older black and white adults. Additional research is needed to examine pathways linking psychosocial distress to cerebrovascular disease risk.

Copyright information:

© 2012 American Heart Association, Inc.

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