Stroke Prevention Behaviors and Associated Factors in Older Adults with High Cardiovascular Risk: Physical, Psychological, and Social Factors

PURPOSE: To investigate the correlates of stroke prevention behaviors among community-dwelling older adults at high cardiovascular risk, focusing on the exploratory indirect role of physical activity in the relationship between social networks and preventive health behaviors. DESIGN: A cross-sectional descriptive study. METHODS: Data were collected from 154 adults aged ≥ 65 years at high cardiovascular risk. Preventive health behaviors were measured using the Cardiovascular Health Behavior Scale - Korean version. Social networks were assessed with the Lubben Social Network Scale - Korean version, and physical activity with the Korean Physical Activity Scale for the Elderly. Mediation analysis was conducted using PROCESS Model 4 with 5,000 bootstrap samples, adjusting for age, sex, living arrangement, waist circumference, and future time perspective. FINDINGS: Social networks (β = .520, p < .001) and physical activity (β = .181, p < .05) were significantly associated with preventive health behaviors, explaining 39.6% of the variance. In the adjusted mediation analysis, physical activity showed a significant indirect association between social networks and overall stroke prevention behaviors (B = .011, 95% bootstrap confidence interval [.0028, .0196]). CONCLUSIONS: Social networks displayed the strongest association with preventive health behaviors.Physical activity may represent an exploratory behavioral link between social networks and overall stroke prevention behaviors, but this finding should be interpreted cautiously because the indirect association was not retained after excluding the physical activity domain from the outcome. CLINICAL RELEVANCE: The findings of this study highlight the importance of strengthening social networks to promote stroke prevention behaviors among older adults with high cardiovascular risk. .