Social Network Trajectories in Myocardial Infarction Versus Ischemic Stroke

Abstract

BackgroundChanges in social networks are rarely examined before and after various diseases because of insufficient data. CHS (The Cardiovascular Health Study) offers an opportunity to compare social network trajectories surrounding well‐adjudicated myocardial infarction (MI) or stroke events. We tested the hypothesis that social networks will be stable after MI and decrease after stroke.Methods and ResultsWe examined trajectories of the Lubben Social Network Scale score (LSNS, range 0–50) before and after vascular events over 11 years. The LSNS assesses engagement in family networks, friends’ networks, and social supports. We used a linear mixed model with repeated measures and fixed effects to compare the change in social network score before and after events in 395 people with MI and 382 with ischemic stroke. Over a mean of 12.4 years of follow‐up for MI and 11.1 years for stroke, we examined an average of 4 social network scores for each participant. We controlled for sociodemographics, baseline cognitive function, and comorbidities. The participants’ mean age was 73.5, 51% were women, and 88% were non‐Hispanic white. After MI, the social network trajectory remained stable compared with the baseline trajectory (−0.06 points per year, adjusted P=0.2356). After stroke, the social network trajectory declined compared with the baseline trajectory (−0.14 points per year, adjusted P=0.0364).ConclusionsSocial networks remained stable after MI and declined after stroke. This small and persistent decline after adjustment for potential confounders is notable because it deviates from stable network trajectories found in CHS participants and is specific to stroke.

Social Network Mapping and Functional Recovery Within 6 Months of Ischemic Stroke

“…30,31 These patterns appears to be accentuated in stroke, compared with myocardial infarction for instance, perhaps because of increased physical and cognitive disabilities. 3,32 Moreover, as shown in our qualitative data, strongly-knit cohesive networks after stroke can strain relationships and communication. 2 Stroke patients report an increase of negative interactions among close network members because of depression in the patient and close network members, increased duties and responsibilities, and reduced interest in social activities.…”

“…1 Stroke, in particular, can disrupt social life more than other disorders. 2,3 Therefore, consideration of social factors in stroke rehabilitation is an unmet need and opportunity.…”

Activating Behavior to Reduce Sedentary Behavior After Stroke: A Nonrandomized Pilot Feasibility Study

“…Social and built environments may also influence sedentary behavior outcomes. Stroke survivors experience changes in social networks (e.g., avoidance of social interactions, restricted participation in social groups) that may influence the frequency of engagement in daily activities ( Dhand et al, 2018 ). The built environment (e.g., stairs, accessible restrooms) may also influence stroke survivors’ engagement in activities ( Hammel et al, 2015 ).…”

Neuropsychiatric Complications after Stroke

“…Social networks decline after stroke. 65,66 Social isolation after stroke has been associated with depressive-like behavior in mice, 67 and social isolation-or even perceived social isolationafter stroke may be a risk factor for PSD. 52,[68][69][70] Premorbid personality traits such as neuroticism, [71][72][73] harm avoidance, 74 and a tendency toward avoidance coping strategies 75 may also play a role in the development of depression after stroke.…”