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Semin Neurol 2017; 37(03): 294-306
DOI: 10.1055/s-0037-1603758
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Systematic Review and Meta-Analysis of Psychosocial Risk Factors for Stroke

C. Elizabeth Lightbody
1   School of Nursing, University of Central Lancashire, Brook Building, Preston, United Kingdom
,
Andrew Clegg
2   School of Health Sciences, University of Central Lancashire, Brook Building, Preston, United Kingdom
,
Kulsum Patel
3   School of Nursing, University of Central Lancashire, Brook Building, Preston, United Kingdom
,
Julie Cook Lucas
4   Research Support Team, Faculty of Health and Wellbeing, University of Central Lancashire, Brook Building, Preston, United Kingdom
,
Hannah Storey
4   Research Support Team, Faculty of Health and Wellbeing, University of Central Lancashire, Brook Building, Preston, United Kingdom
,
Maree L. Hackett
5   School of Nursing, University of Central Lancashire, Brook Building, Preston, United Kingdom
6   Neurological and Mental Health Division, The George Institute for Global Health, University of New South Wales, Sydney, Australia
,
Dame Caroline L. Watkins
7   Faculty of Health and Wellbeing, University of Central Lancashire, Brook Building, Preston, United Kingdom
› Author Affiliations
Further Information

Publication History

Publication Date:
31 July 2017 (online)

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Abstract

Several studies have assessed the link between psychosocial risk factors and stroke; however, the results were inconsistent. We have conducted a systemic review and meta-analysis of cohort or case-control studies to ascertain the association between psychosocial risk factors (psychological, vocational, behavioral, interpersonal, and neuropsychological) and the risk of stroke. Systematic searches were undertaken in MEDLINE, EMBASE, CINAHL, PsycINFO, and the Cochrane Database of Systematic Reviews between 2000 and January 2017. Two reviewers independently screened titles, abstracts, and full texts. One reviewer assessed quality and extracted data, which was checked by a second reviewer. For studies that reported risk estimates, a meta-analysis was performed. We identified 41 cohort studies and 5 case-control studies. No neuropsychological papers were found. Overall, pooled adjusted estimates showed that all other psychosocial risk factors were independent risk factors for stroke. Psychological factors increased the risk of stroke by 39% (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.27–1.51), vocational by 35% (HR, 1.35; 95% CI, 1.20–1.51), and interpersonal by 16% (HR, 1.16; 95% CI, 1.03–1.31), and the effects of behavioral factors were equivocal (HR, 0.94; 95% CI, 0.20–4.31). The meta-analyses were affected by heterogeneity. Psychosocial risk factors are associated with an increased risk of stroke.

Keywords

stroke - psychosocial - risk factor

Contribution of the Author

CEL, CW, KP, MLH, and AC conceived the concept of the study and contributed to the design of the study. AC, CEL, JCL, KP, and HS screened the studies; CEL, JCL, KP, HS, AC and MLH data extracted the literature. AC performed the data analysis, CEL, AC, and KP drafted the manuscript and all authors undertook a critical read and approved the final manuscript.


 

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