Green space is associated with new-onset stroke among Chinese middle-aged and older adults: data from China Health and Retirement Longitudinal Study (CHARLS)
Background and aimsThe relationship between green space and new-onset stroke is inconclusive. This study aimed to investigate the association between green space and stroke risk among Chinese middle-aged and older adults.MethodsData were taken from participants aged ≥45 years in the China Health and...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1424510/full |
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| author | Qiong Lu Qiong Lu Cheng Lian Xinglin Chen Xinglin Chen |
| author_facet | Qiong Lu Qiong Lu Cheng Lian Xinglin Chen Xinglin Chen |
| author_sort | Qiong Lu |
| collection | DOAJ |
| description | Background and aimsThe relationship between green space and new-onset stroke is inconclusive. This study aimed to investigate the association between green space and stroke risk among Chinese middle-aged and older adults.MethodsData were taken from participants aged ≥45 years in the China Health and Retirement Longitudinal Study (CHARLS). Baseline data were collected in 2011 and new-onset stroke data were gathered during follow-up in 2013, 2015, 2018, and 2020. Multivariate Cox regression models were constructed to investigate the association between green space and stroke risk. Subgroup analysis was also performed.ResultsA total of 13,696 participants with a mean age of 59.3 ± 9.3 years were included. After a mean follow-up duration of 6.32 years, there were 728 stroke events during a total of 86,530 person-years of follow-up. The study found a L-shaped relationship between green space and the risk of new-onset stroke in participants. By using a two-piecewise linear regression model, we calculated that the inflection point for the per capita park green area was 10.61 square meters per person (log-likelihood ratio test p = 0.041). On the left of the inflection point, we observed a negative relationship between green space and the incidence of stroke (HR: 0.89, 95% CI: 0.84–0.94, p = 0.0001). On the right side of the inflection point, however, the relationship tended to be saturated (HR: 0.97, 95% CI: 0.94–1.01, p = 0.2111).ConclusionOur study found that the relationship between green space and the risk of new-onset stroke follows a L-shaped curve. A lower amount of green space is associated with an increased risk of new-onset stroke. These findings require confirmation in future studies. |
| format | Article |
| id | doaj-art-1305066cd7434f3dae97e4947f4e3b4d |
| institution | Kabale University |
| issn | 2296-2565 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj-art-1305066cd7434f3dae97e4947f4e3b4d2025-01-03T05:10:18ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-01-011210.3389/fpubh.2024.14245101424510Green space is associated with new-onset stroke among Chinese middle-aged and older adults: data from China Health and Retirement Longitudinal Study (CHARLS)Qiong Lu0Qiong Lu1Cheng Lian2Xinglin Chen3Xinglin Chen4Quyi Research Institute Chinese National Academy of Arts, Beijing, ChinaAcademic Department, Chinese National Academy of Folk Art, Beijing, ChinaDepartment of Cardiology, Xi’an No.3 Hospital, The Affiliated Hospital of Northwest University, Xi’an, ChinaAcademic Department, Chinese National Academy of Folk Art, Beijing, ChinaDepartment of Epidemiology and Biostatistics, Empower U, X&Y Solutions Inc., Boston, MA, United StatesBackground and aimsThe relationship between green space and new-onset stroke is inconclusive. This study aimed to investigate the association between green space and stroke risk among Chinese middle-aged and older adults.MethodsData were taken from participants aged ≥45 years in the China Health and Retirement Longitudinal Study (CHARLS). Baseline data were collected in 2011 and new-onset stroke data were gathered during follow-up in 2013, 2015, 2018, and 2020. Multivariate Cox regression models were constructed to investigate the association between green space and stroke risk. Subgroup analysis was also performed.ResultsA total of 13,696 participants with a mean age of 59.3 ± 9.3 years were included. After a mean follow-up duration of 6.32 years, there were 728 stroke events during a total of 86,530 person-years of follow-up. The study found a L-shaped relationship between green space and the risk of new-onset stroke in participants. By using a two-piecewise linear regression model, we calculated that the inflection point for the per capita park green area was 10.61 square meters per person (log-likelihood ratio test p = 0.041). On the left of the inflection point, we observed a negative relationship between green space and the incidence of stroke (HR: 0.89, 95% CI: 0.84–0.94, p = 0.0001). On the right side of the inflection point, however, the relationship tended to be saturated (HR: 0.97, 95% CI: 0.94–1.01, p = 0.2111).ConclusionOur study found that the relationship between green space and the risk of new-onset stroke follows a L-shaped curve. A lower amount of green space is associated with an increased risk of new-onset stroke. These findings require confirmation in future studies.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1424510/fullgreen spaceChina Health and Retirement Longitudinal Studyagingstrokecohort |
| spellingShingle | Qiong Lu Qiong Lu Cheng Lian Xinglin Chen Xinglin Chen Green space is associated with new-onset stroke among Chinese middle-aged and older adults: data from China Health and Retirement Longitudinal Study (CHARLS) Frontiers in Public Health green space China Health and Retirement Longitudinal Study aging stroke cohort |
| title | Green space is associated with new-onset stroke among Chinese middle-aged and older adults: data from China Health and Retirement Longitudinal Study (CHARLS) |
| title_full | Green space is associated with new-onset stroke among Chinese middle-aged and older adults: data from China Health and Retirement Longitudinal Study (CHARLS) |
| title_fullStr | Green space is associated with new-onset stroke among Chinese middle-aged and older adults: data from China Health and Retirement Longitudinal Study (CHARLS) |
| title_full_unstemmed | Green space is associated with new-onset stroke among Chinese middle-aged and older adults: data from China Health and Retirement Longitudinal Study (CHARLS) |
| title_short | Green space is associated with new-onset stroke among Chinese middle-aged and older adults: data from China Health and Retirement Longitudinal Study (CHARLS) |
| title_sort | green space is associated with new onset stroke among chinese middle aged and older adults data from china health and retirement longitudinal study charls |
| topic | green space China Health and Retirement Longitudinal Study aging stroke cohort |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1424510/full |
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