ArticleStroke2008
Stroke disparities in older Americans: is wealth a more powerful indicator of risk than income and education?
Article in Stroke, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
44 citing papers in PubMed, 102 citations in OpenAlex.
- Community resilience and stroke outcomes in older adults: beyond rural-urban classifications.Frontiers in public health · 2025Article
- POINT: Pipeline for Offline Conversion and Integration of Geocodes and Neighborhood Data.Applied clinical informatics · 2023Article
- Association of Education With Dementia Incidence Stratified by Ethnicity and Nativity in a Cohort of Older Asian American Individuals.JAMA network open · 2023Article
- Construction and validation of CAPSES scale as a composite indicator of SES for health research: an application to modeling social determinants of cardiovascular diseases.BMC public health · 2023Article
- A Machine Learning Approach to Support Urgent Stroke Triage Using Administrative Data and Social Determinants of Health at Hospital Presentation: Retrospective Study.Journal of medical Internet research · 2023Article
- The Long Arm of Prospective Childhood Income for Mature Adult Health in the United States.Journal of health and social behavior · 2022Article
- Social Determinants of Stroke Hospitalization and Mortality in United States' Counties.Journal of clinical medicine · 2022Article
- Research on risk factors of ischemic cerebrovascular disease in postmenopausal women based on the social-ecological model.European journal of medical research · 2022Article
- Social relations and health in older people in Spain using SHARE survey data.BMC geriatrics · 2022Article
- A cohort study on the relationship between education level and high-risk population of stroke.Ibrain · 2021Article
- A Scoping Review of the Association of Social Disadvantage and Cerebrovascular Disease Confirmed by Neuroimaging and Neuropathology.International journal of environmental research and public health · 2021Article
- Associations between education and dementia in the Caribbean and the United States: An international comparison.Alzheimer's & dementia (New York, N. Y.) · 2021Article
- Childhood Misfortune and Late-Life Stroke Incidence, 2004-2014.The Gerontologist · 2020Article
- Article
- Association between socioeconomic status and incident stroke in China.Journal of epidemiology and community health · 2020Article
- Effects of socioeconomic status on risk of ischemic stroke: a case-control study in the Guangzhou population.BMC public health · 2019Article
- Incidence of dementia after age 90 in a multiracial cohort.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2019Article
- The reciprocal relationship between material factors and health in the life course: evidence from SHARE and ELSA.European journal of ageing · 2018Article
- Education, sex and risk of stroke: a prospective cohort study in New South Wales, Australia.BMJ open · 2018Article
- Contribution of Socioeconomic Status at 3 Life-Course Periods to Late-Life Memory Function and Decline: Early and Late Predictors of Dementia Risk.American journal of epidemiology · 2017Article
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
Abstract
background and purposeThis study examines the independent effect of wealth, income, and education on stroke and how these disparities evolve throughout middle and old age in a representative cohort of older Americans.
methodsStroke-free participants in the Health and Retirement Study (n=19,565) were followed for an average of 8.5 years. Total wealth, income, and education assessed at baseline were used in Cox proportional hazards models to predict time to stroke. Separate models were estimated for 3 age-strata (50 to 64, 65 to 74, and >or=75), and incorporating risk factor measures (smoking, physical activity, body mass index, hypertension, diabetes, and heart disease).
results1542 subjects developed incident stroke. Higher education predicted reduced stroke risk at ages 50 to 64, but not after adjustment for wealth and income. Wealth and income were independent risk factors for stroke at ages 50 to 64. Adjusted hazard ratios comparing the lowest decile with the 75th-90th percentiles were 2.3 (95% CI 1.6, 3.4) for wealth and 1.8 (95% CI 1.3, 2.6) for income. Risk factor adjustment attenuated these effects by 30% to 50%, but coefficients for both wealth (HR=1.7, 95% CI 1.2, 2.5) and income (HR=1.6, 95% CI 1.2, 2.3) remained significant. Wealth, income, and education did not consistently predict stroke beyond age 65.
conclusionsWealth and income are independent predictors of stroke at ages 50 to 64 but do not predict stroke among the elderly. This age patterning might reflect buffering of the negative effect of low socioeconomic status by improved access to social and health care programs at old ages, but may also be an artifact of selective survival.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.