The association of social isolation and family structure on stroke-specific quality of life in a community-based study

PURPOSE: Quality of Life (QOL) is a critical patient-centered outcome for individuals who have experienced stroke. This study examined the association of social isolation and family structure with Stroke-Specific QOL (SSQOL). METHODS: Participants were stroke survivors enrolled in the Brain Attack Surveillance in Corpus Christi (BASIC) study in Nueces County, Texas who completed 90-day post-stroke follow-up interviews between October 2019 and June 2023. Interviewers assessed QOL using the SSQOL scale, social isolation using the Patient-Reported Outcomes Measurement Information System (PROMIS) scale. Family structure was assessed based on marital status, family size, and whether adult children were living within 10 miles of the patient. Linear models were developed to analyze the relationship between social isolation and SSQOL with successive adjustment for demographic, clinical, socioeconomic, and familial variables from interviews and medical records. RESULTS: Among 706 stroke survivors (median age = 64, 36% Non-Hispanic White and 64% Mexican American), median PROMIS social isolation score was 44 (IQR: 34.8-51.6) and median SSQOL was 3.67 (IQR: 2.75-4.50). The average family size was 2.18 people and 50% of participants were married while 60% had a child living within 10 miles of them. A consistent negative association between social isolation and SSQOL scores was observed across all adjusted models (fully adjusted [Formula: see text]0.77, 95% CI = (- 0.88, - 0.65), p < 0.01), while family structure was not associated with SSQOL. CONCLUSIONS: Social isolation was negatively associated with SSQOL. There was no association between family structure and SSQOL. This study highlights the significance of modifiable psychosocial factors, such as social isolation, as potential key elements in stroke recovery.