Access to neighborhood destinations that offer opportunities for physical activity and socialization is associated with favorable post-stroke outcomes

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: incident stroke (n=1786). Intervention: Destinations within 0.5-miles around residence. Primary outcome: Functioning (activities of daily living/instrumental ADL) in moderate-severe stroke survivors (MD -0.12, 95% CI -0.22, -0.01).

Q: What does this research mean for the field?

Greater access to neighborhood destinations offering physical activity and socialization opportunities is associated with more favorable functioning and quality of life among moderate-to-severe stroke survivors. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Leanna Delhey; Jon Zelner; Xu Shi; Lewis B. Morgenstern; Devin L Brown; Melinda A. Smith; Erin Case; Lynda D. Lisabeth

doi:10.1016/j.jstrokecerebrovasdis.2026.108545

January 2, 2026Journal of Stroke and Cerebrovascular DiseasesOpen Access

Access to neighborhood destinations that offer opportunities for physical activity and socialization is associated with favorable post-stroke outcomes

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Key result

More nearby neighborhood destinations linked to improved functioning and quality of life after moderate-severe stroke.

Why the study?

Does access to neighborhood destinations improve post-stroke outcomes in incident stroke survivors?

Key Points

To examine associations between destination density near a stroke survivor's home—providing venues for socialization and physical activity—and functional, cognitive, and psychological outcomes over 12 months.
Analyzed data from 1,786 non-Hispanic white and Mexican American incident stroke survivors in the Brain Attack Surveillance in Corpus Christi project (2009–2019) in Texas.
Quantified destinations (stores, restaurants, recreational facilities) within a 0.5-mile residential radius and assessed outcomes at 3, 6, and 12 months post-stroke.
Utilized adjusted linear mixed models evaluating interactions with follow-up time and stroke severity categorized via the NIH Stroke Scale (mild: <5; moderate-to-severe: ≥5).
Stroke severity significantly modified associations with post-stroke functioning (p = 0.09) and quality of life (p = 0.05), whereas follow-up duration showed no interaction (p > 0.25).
Among moderate-to-severe stroke survivors, higher destination counts were associated with improved functioning (mean difference = -0.12, 95% CI: -0.22 to -0.01) and higher quality of life (mean difference = 0.16, 95% CI: 0.03 to 0.30).
No statistically significant associations were identified among survivors of mild stroke, nor were associations observed for cognition or depression across the cohort (p > 0.05).

Study Design

Type

Cohort (n=1,786)

Structured PICO

Does access to neighborhood destinations improve post-stroke outcomes in incident stroke survivors?

P

Population

1,786 non-Hispanic white and Mexican American incident stroke survivors (median age 64, 45% female) followed for up to 12 months.

E

Exposure

Higher count of destinations (e.g., restaurants, recreation centers, stores) within 0.5-miles around survivors' residences

C

Comparator

Lower count of destinations within 0.5-miles around survivors' residences

O

Outcome

Cognition (Modified Mini-Mental State Examination), functioning (ADL/IADL), health-related quality of life (abbreviated Stroke-Specific Quality of Life scale), and depression (Patient Health Questionnaire-8) at 3, 6, and 12 months poststrokepatient reported

Main Result

Mean Difference: -0.12 (95% CI -0.22–-0.01)

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Implication

Access to nearby neighborhood destinations is associated with better functioning and quality of life in the first year after moderate-severe stroke.

Abstract

OBJECTIVE: Assess associations between destinations near stroke survivor's residence - places like restaurants, recreation centers, and stores that offer opportunities for physical activity and socialization outside of the home and work - and their poststroke outcomes. METHODS: We included non-Hispanic white and Mexican American incident stroke survivors enrolled in the Brain Attack Surveillance in Corpus Christi project (2009-19), a population-based cohort in Texas. EXPOSURE: count of destinations within 0.5-miles around survivors' residences. Outcomes assessed at approximately 3-, 6-, and 12-months poststroke: cognition (Modified Mini-Mental State Examination), functioning (activities of daily living (ADL)/instrumental ADL), health-related quality of life (abbreviated Stroke-Specific Quality of Life scale), and depression (Patient Health Questionnaire-8). We fit adjusted linear mixed models and considered interactions with follow-up time and stroke severity (NIH stroke scale - mild (<5), moderate-severe (≥5)). RESULTS: We included 1,786 survivors who completed 3 (N = 1,321), 6 (N = 677), or 12-month interviews (N = 652). Median age was 64 years, 55% male, and 74% mild stroke. Stroke severity modified associations with functioning (p = 0.09) and quality of life (p = 0.05), follow-up time did not (p > 0.25). Among moderate-severe stroke survivors, more destinations were associated with more favorable functioning (mean difference=-0.12, 95% CI=-0.22, -0.01) and quality of life (mean difference=0.16, 95% CI=0.03, 0.30). No associations were observed among mild stroke survivors or with cognition or depression (p > 0.05). INTERPRETATION: Among moderate-severe stroke survivors, more nearby destinations were associated with more favorable functioning and quality of life in the first year. Future research is needed to explore if specific types of destinations may support more favorable outcomes.

Discussion

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Cite This Study

Delhey et al. (2026) conducted a cohort in incident stroke (n=1,786). Destinations within 0.5-miles around residence was evaluated on Functioning (activities of daily living/instrumental ADL) in moderate-severe stroke survivors (MD -0.12, 95% CI -0.22, -0.01). Among moderate-severe stroke survivors, more nearby destinations were associated with more favorable functioning (MD -0.12; 95% CI -0.22, -0.01) and quality of life.

synapsesocial.com/papers/6a15cde7b2e0231f158304a8 https://doi.org/10.1016/j.jstrokecerebrovasdis.2026.108545

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Access to neighborhood destinations that offer opportunities for physical activity and socialization is associated with favorable post-stroke outcomes

Key Points

Study Design

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Access to neighborhood destinations that offer opportunities for physical activity and socialization is associated with favorable post-stroke outcomes

Key Points

Study Design

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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