Household Structure and Weak Social Networks Increase Risk of Recurrent Vascular Events

The “aging of America” places substantial pressure on family/friend networks, as they are often caregivers for chronically ill older adults.  Shifts in family/friend structure vary by race-ethnicity, suggesting that different networks than traditionally thought are being accessed to provide support to manage chronic disease.  The Stroke Warning information and Faster Treatment (SWIFT) trial assessed the role of social support and social networks among stroke patients.  SWIFT demonstrated that dense households and weak social networks increase risk of recurrent vascular events among 1193 participants (51% Hispanics, 26% whites, and 17% Blacks) We report that 24% live alone, 23% lived with spouse/partner only, and 21% live in dense households. In adjusted logistic models, post stroke vascular events were associated with dense households [RR 1.5 (95% CI: 1.1 - 1.9)], weak family networks [RR 1.9 (95% CI: 1.4 - 2.8] and weak friend networks [RR 1.5 (95% CI: 1.0 - 2.5). The fact that dense households are associated with higher vascular incidence demonstrates that bigger network size is not always protective. Social isolation increases risk of vascular events post stroke; that different types of networks (friends versus family) may impact differentially on health behaviors (physical activity versus stroke preparedness); that living arrangements may be associated with vascular risk factors including hypertension and recurrent stroke risk; and that these effects vary across different race-ethnic groups. Our work has contributed to an expanding literature on social support/social networks, which has suggested the upmost importance social support/networks on the multiple dimensions of older adults’ health.