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

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 ( 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.