LAUSR

Introduction: Although the impacts of marital status on health have long been recognized, little is known about its role in stroke outcomes. The study examined the association of marital status with neuropsychiatric, cognitive, functional, and quality of life outcomes at 90 days post-stroke in a population-based sample. Methods: Data were obtained from the Brain Attack Surveillance in Corpus Christi (BASIC) project (2009-2016). Post-stroke outcomes included neurological status assessed by the National Institutes of Health Stroke Scale, cognitive function assessed by the Modified Mini-Mental State Examination, functioning assessed by an activities of daily living (ADL)/instrumental activities of daily living (IADL) score, depression assessed by the 8-item Patient Health Questionnaire, and quality of life assessed by the short-form Stroke Specific Quality of Life scale. Linear or Tobit regression models were used to examine the association between marital status and stroke outcomes, accounting for attrition. Results: Among 1,226 ischemic or hemorrhagic cases, mean age was 67.6 (SD=12.3), half were women, and three-fifths were Mexican American; 23.0% were widowed, 20.1% were divorced/separated, and 8.4% were never married. Widowed participants were more likely to be female, aged above 75, and less educated than other groups. After adjustment for age, sex, ethnicity, education and stroke severity, compared with those married, those widowed had significantly worse cognitive function and quality of life, those never married had worse neurological and cognitive outcomes, and those divorced/separated had more depressive symptoms and poorer quality of life (Table). Conclusions: Being unmarried at stroke onset is associated with worse outcomes after stroke, and the outcome profiles vary by marital status. Further research should investigate potential mechanisms and develop interventions to improve outcomes of unmarried stroke survivors.