Social ties and cognitive recovery after stroke: does social integration promote cognitive resilience?
OBJECTIVE
Little is known about the possible effects of social resources on stroke survivors' level and change in cognitive outcomes. Understanding this association may help us identify strategies to improve stroke recovery and help elucidate the etiology of dementia.


METHODS
We examined the relationship of social ties and social support to cognitive function and cognitive change 6 months after stroke. Participants in the Families in Recovery from Stroke Trial (FIRST) (n = 272) were interviewed approximately 17 days (baseline) and 6 months (follow-up) after stroke. Cognition was assessed with the Mini Mental State Examination (MMSE) and a summary battery of 7 neuropsychological tests. Median-based regression was used to model cognitive outcomes by level of baseline intimate, personal and organizational social ties and received emotional and instrumental support.


RESULTS
Baseline social ties and emotional support independently predicted 6-month Cognitive Summary Scores. Emotional support also predicted greater improvements in Cognitive Summary Scores from baseline to the 6-month follow-up. No other social exposures predicted improvements in the MMSE or the Cognitive Summary.


CONCLUSIONS
Our results suggest that emotional support may promote cognitive resilience while social ties provide cognitive reserve that protects against impaired cognition after stroke. Social ties did not predict cognitive recovery however, so reverse causation cannot be ruled out.
Columbia University Mailman School of Public Health, New York, NY 10032, USA. mglymour@hsph.harvard.edu
M Maria
MM
Glymour
Jennifer
J
Weuve
Martha E
ME
Fay
Thomas
T
Glass
Lisa F
LF
Berkman
D000368:Aged; D000369:Aged, 80 and over; D010054:Brief Psychiatric Rating Scale; D003071:Cognition; D003072:Cognition Disorders / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology*; D015331:Cohort Studies; D004644:Emotions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies; D020127:Recovery of Function; D012944:Social Support; D020521:Stroke / Q000150:complications / Q000523:psychology*