Parents survive longer after stroke than childless individuals: a prospective cohort study of Swedes over the age of 65.


Journal

European journal of public health
ISSN: 1464-360X
Titre abrégé: Eur J Public Health
Pays: England
ID NLM: 9204966

Informations de publication

Date de publication:
01 12 2019
Historique:
pubmed: 21 6 2019
medline: 31 10 2020
entrez: 21 6 2019
Statut: ppublish

Résumé

Parents have lower mortality than childless individuals, and one possible explanation is support provided by adult children. Since stroke often results in functional limitations, support from children may be of particular importance. Here, we examine whether the presence of children matters for survival after stroke among older Swedish men and women. This prospective cohort study linked data from several Swedish population registers. Individuals aged 65 years and older hospitalized for their first ischemic stroke between 1998 and 2002 (33 960 men and 36 189 women) were followed 12 years for survival. Hazard ratios for all-cause mortality were calculated by number of children using Cox proportional hazard regression stratified by sex and marital status and adjusted for education, income and comorbidities. Childlessness and having only one child was associated with higher mortality after stroke compared with having two children among men and women. The relative survival disadvantage of childless individuals was largest among married women [HR 1.28 (1.18-1.39)] and smallest among married men [1.09 (1.03-1.15)]. The differences in predicted median survival between childless individuals and those with two children were 4 and 7 months among married and unmarried men, and 15 and 9 months among married and unmarried women, respectively. Having children is associated with a longer survival after stroke among men and women regardless of marital status. Our findings further suggest that the presence of children is especially connected to married women's survival. These results may have implications for the improvement of informal care for childless older individuals.

Sections du résumé

BACKGROUND
Parents have lower mortality than childless individuals, and one possible explanation is support provided by adult children. Since stroke often results in functional limitations, support from children may be of particular importance. Here, we examine whether the presence of children matters for survival after stroke among older Swedish men and women.
METHODS
This prospective cohort study linked data from several Swedish population registers. Individuals aged 65 years and older hospitalized for their first ischemic stroke between 1998 and 2002 (33 960 men and 36 189 women) were followed 12 years for survival. Hazard ratios for all-cause mortality were calculated by number of children using Cox proportional hazard regression stratified by sex and marital status and adjusted for education, income and comorbidities.
RESULTS
Childlessness and having only one child was associated with higher mortality after stroke compared with having two children among men and women. The relative survival disadvantage of childless individuals was largest among married women [HR 1.28 (1.18-1.39)] and smallest among married men [1.09 (1.03-1.15)]. The differences in predicted median survival between childless individuals and those with two children were 4 and 7 months among married and unmarried men, and 15 and 9 months among married and unmarried women, respectively.
CONCLUSIONS
Having children is associated with a longer survival after stroke among men and women regardless of marital status. Our findings further suggest that the presence of children is especially connected to married women's survival. These results may have implications for the improvement of informal care for childless older individuals.

Identifiants

pubmed: 31220242
pii: 5443281
doi: 10.1093/eurpub/ckz053
pmc: PMC6896977
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1090-1095

Informations de copyright

© The Author(s) 2019. Published by Oxford University Press on behalf of the European Public Health Association.

Références

Soc Sci Med. 2012 Jul;75(1):46-59
pubmed: 22534377
J Health Soc Behav. 2011 Jun;52(2):145-61
pubmed: 21673143
Top Stroke Rehabil. 2003 Spring;10(1):29-58
pubmed: 12970830
Soc Sci Med. 2010 Jun;70(11):1847-57
pubmed: 20299140
Patient Educ Couns. 2013 Nov;93(2):169-76
pubmed: 23870177
BMC Neurol. 2016 May 27;16:80
pubmed: 27411309
Neuroepidemiology. 2013;40(4):240-6
pubmed: 23364278
Sci Rep. 2016 Jan 13;6:19351
pubmed: 26758416
Soc Sci Med. 2014 Dec;122:148-56
pubmed: 25441327
Clin Rehabil. 2016 Aug;30(8):811-31
pubmed: 26330297
BMC Public Health. 2011 Jun 09;11:450
pubmed: 21658213
Lancet. 2011 May 14;377(9778):1693-702
pubmed: 21571152
J Epidemiol Community Health. 2017 May;71(5):424-430
pubmed: 28292784
Demography. 2011 May;48(2):481-506
pubmed: 21526396
Int J Cancer. 2003 Jun 10;105(2):261-6
pubmed: 12673689
Popul Stud (Camb). 2016 Jul;70(2):217-38
pubmed: 27362776
Am Heart J. 2010 Feb;159(2):215-221.e6
pubmed: 20152219
Med Care. 2005 Nov;43(11):1130-9
pubmed: 16224307
J Behav Med. 2006 Aug;29(4):377-87
pubmed: 16758315
Popul Stud (Camb). 2006 Mar;60(1):55-71
pubmed: 16464775
J Am Heart Assoc. 2016 Dec 14;5(12):
pubmed: 27974292
Circulation. 2018 Jul 17;138(3):232-240
pubmed: 29581124
Eur J Epidemiol. 2009;24(1):9-16
pubmed: 19145406
Stroke. 2009 Apr;40(4):1050-8
pubmed: 19211494
J Neurol Neurosurg Psychiatry. 2009 Aug;80(8):881-7
pubmed: 19332423

Auteurs

Anna C Meyer (AC)

Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.

Jenny Torssander (J)

Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden.

Mats Talbäck (M)

Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.

Karin Modig (K)

Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH