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Association between white matter hyperintensity volume and social functioning limitations among stroke survivors

  • Flora G. Chang
    Affiliations
    Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA

    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
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  • Natalia S. Rost
    Affiliations
    Department of Neurology, J. Philip Kistler Stroke Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA
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  • JoAnn E. Manson
    Affiliations
    Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA

    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
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  • Julie E. Buring
    Affiliations
    Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA

    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
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  • Pamela M. Rist
    Correspondence
    Corresponding author at: Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, 900 Commonwealth Avenue, 3rd floor, Boston, MA 02215.
    Affiliations
    Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA

    Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
    Search for articles by this author

      Abstract

      Objective

      Existing literature on white matter hyperintensity volume (WMHV) in stroke patients has rarely focused on post-stroke outcomes related to social functioning limitations, such as transportation, social interaction, food preparation, grocery shopping, and housekeeping. Using prospective data from the VITamin D and OmegA-3 TriaL (VITAL) study, we evaluated the association between WMHV and social functioning limitations among 151 ischemic stroke patients.

      Materials and methods

      WMHV was ascertained from magnetic resonance imaging (MRI) collected at the time of the stroke event using a validated semiautomated method, and social functioning limitations were assessed using a stroke outcomes questionnaire administered a median of 1.25 years after the date of the MRI scan. Logistic regression was used to explore the association between WMHV and social functioning limitations.

      Results

      After adjusting for age and sex, a statistically significant association was found between WMHV and limitations in social interaction (OR=2.82; 95% CI: 1.21-7.55). Increased risks were seen for limitations related to food preparation (OR=2.06; 95% CI: 0.99-4.54), transportation (OR=1.39; 95% CI: 0.85-2.27), and housekeeping (OR=1.37; 95% CI: 0.91-2.11); however, the associations did not reach statistical significance. We observed no association between WMHV and limitations in grocery shopping (OR=1.08; 95% CI: 0.61-1.89).

      Conclusions

      Future studies are needed to further explore the biological mechanisms underlying the relationship with limitations in social interaction and to replicate our findings using a larger and more diverse study sample.

      Key Words

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