Greenspace exposure and poststroke disability: A nationwide longitudinal study
Introduction: Exposure to greenspace has been reported to reduce stroke mortality, but there is a lack of evidence regarding poststroke disability. This study aimed to investigate the association between long-term greenspace exposure and the risk of poststroke disability. Methods: Based on the China...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-11-01
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| Series: | Ecotoxicology and Environmental Safety |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0147651322010351 |
| _version_ | 1798046469019664384 |
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| author | Man Cao Tianjia Guan Mingkun Tong Jiajianghui Li Hong Lu Xinyue Yang Ruohan Wang Hengyi Liu Baohua Chao Yuanli Liu Tao Xue |
| author_facet | Man Cao Tianjia Guan Mingkun Tong Jiajianghui Li Hong Lu Xinyue Yang Ruohan Wang Hengyi Liu Baohua Chao Yuanli Liu Tao Xue |
| author_sort | Man Cao |
| collection | DOAJ |
| description | Introduction: Exposure to greenspace has been reported to reduce stroke mortality, but there is a lack of evidence regarding poststroke disability. This study aimed to investigate the association between long-term greenspace exposure and the risk of poststroke disability. Methods: Based on the China National Stroke Screening Survey from 2013 to 2019, a total of 65,892 visits from 28,085 stroke survivors with ≥ 2 visits were included in this longitudinal study. Long-term greenspace exposure was assessed by a 3-year average of the Normalized Difference Vegetation Index (NDVI) and the proportion of green land cover according to participants’ residential communities. Poststroke functional status was assessed with the modified Ranking Score (mRS) at each visit; a cutoff score > 2 indicated disability. Fixed effects regressions were used to examine the association of greenspace exposure with continuous mRS scores or binary indicators for disability. Results: The annual mean NDVI value was 0.369 (standard deviation = 0.120) for all visits among stroke survivors. With full adjustments, each 0.05 increase in NDVI was associated with a 0.056-unit (95 % confidence interval (CI): 0.034, 0.079) decrease in the mRS score and a 46.6 % (95 % CI: 10.0 %, 68.3 %) lower risk of poststroke disability. An L-shaped curve was observed for the nonlinear associations between NDVI and mRS score or disability. Additionally, each 1 % increase in grasslands, savannas, forest, and croplands was associated with 0.008- (95 % CI: 0.002, 0.014), 0.003- (95 % CI: 0.001, 0.005), 0.001- (95 % CI: −0.015, 0.018), and 0.002-unit (95 % CI: −0.003, 0.007) decreases in the mRS score, respectively. Conclusions: Increasing greenspace was inversely associated with mRS score. Greenspace planning can be a potential intervention to prevent poststroke disability. |
| first_indexed | 2024-04-11T23:38:03Z |
| format | Article |
| id | doaj.art-7dea9ccb378a4e6780d255bd61712802 |
| institution | Directory Open Access Journal |
| issn | 0147-6513 |
| language | English |
| last_indexed | 2024-04-11T23:38:03Z |
| publishDate | 2022-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Ecotoxicology and Environmental Safety |
| spelling | doaj.art-7dea9ccb378a4e6780d255bd617128022022-12-22T03:56:53ZengElsevierEcotoxicology and Environmental Safety0147-65132022-11-01246114195Greenspace exposure and poststroke disability: A nationwide longitudinal studyMan Cao0Tianjia Guan1Mingkun Tong2Jiajianghui Li3Hong Lu4Xinyue Yang5Ruohan Wang6Hengyi Liu7Baohua Chao8Yuanli Liu9Tao Xue10School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, ChinaSchool of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, ChinaInstitute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, ChinaInstitute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, ChinaInstitute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, ChinaCollege of Environmental Sciences and Engineering, Peking University, Beijing, ChinaInstitute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, ChinaInstitute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, ChinaThe General Office of Stroke Prevention Project Committee, National Health Commission of the People’s Republic of China, Beijing, ChinaSchool of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China; Corresponding authors.Institute of Reproductive and Child Health / National Health Commission Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China; Corresponding authors.Introduction: Exposure to greenspace has been reported to reduce stroke mortality, but there is a lack of evidence regarding poststroke disability. This study aimed to investigate the association between long-term greenspace exposure and the risk of poststroke disability. Methods: Based on the China National Stroke Screening Survey from 2013 to 2019, a total of 65,892 visits from 28,085 stroke survivors with ≥ 2 visits were included in this longitudinal study. Long-term greenspace exposure was assessed by a 3-year average of the Normalized Difference Vegetation Index (NDVI) and the proportion of green land cover according to participants’ residential communities. Poststroke functional status was assessed with the modified Ranking Score (mRS) at each visit; a cutoff score > 2 indicated disability. Fixed effects regressions were used to examine the association of greenspace exposure with continuous mRS scores or binary indicators for disability. Results: The annual mean NDVI value was 0.369 (standard deviation = 0.120) for all visits among stroke survivors. With full adjustments, each 0.05 increase in NDVI was associated with a 0.056-unit (95 % confidence interval (CI): 0.034, 0.079) decrease in the mRS score and a 46.6 % (95 % CI: 10.0 %, 68.3 %) lower risk of poststroke disability. An L-shaped curve was observed for the nonlinear associations between NDVI and mRS score or disability. Additionally, each 1 % increase in grasslands, savannas, forest, and croplands was associated with 0.008- (95 % CI: 0.002, 0.014), 0.003- (95 % CI: 0.001, 0.005), 0.001- (95 % CI: −0.015, 0.018), and 0.002-unit (95 % CI: −0.003, 0.007) decreases in the mRS score, respectively. Conclusions: Increasing greenspace was inversely associated with mRS score. Greenspace planning can be a potential intervention to prevent poststroke disability.http://www.sciencedirect.com/science/article/pii/S0147651322010351StrokeDisabilityGreenspaceModified ranking score, Normalized difference vegetation index |
| spellingShingle | Man Cao Tianjia Guan Mingkun Tong Jiajianghui Li Hong Lu Xinyue Yang Ruohan Wang Hengyi Liu Baohua Chao Yuanli Liu Tao Xue Greenspace exposure and poststroke disability: A nationwide longitudinal study Ecotoxicology and Environmental Safety Stroke Disability Greenspace Modified ranking score, Normalized difference vegetation index |
| title | Greenspace exposure and poststroke disability: A nationwide longitudinal study |
| title_full | Greenspace exposure and poststroke disability: A nationwide longitudinal study |
| title_fullStr | Greenspace exposure and poststroke disability: A nationwide longitudinal study |
| title_full_unstemmed | Greenspace exposure and poststroke disability: A nationwide longitudinal study |
| title_short | Greenspace exposure and poststroke disability: A nationwide longitudinal study |
| title_sort | greenspace exposure and poststroke disability a nationwide longitudinal study |
| topic | Stroke Disability Greenspace Modified ranking score, Normalized difference vegetation index |
| url | http://www.sciencedirect.com/science/article/pii/S0147651322010351 |
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