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ORIGINAL RESEARCH article

Front. Public Health
Sec. Aging and Public Health
Volume 12 - 2024 | doi: 10.3389/fpubh.2024.1424510
This article is part of the Research Topic Impact of Environmental Factors on Healthy Aging: Behavioral Pathways and Health Outcomes View all articles

Green space is associated with new-onset stroke among Chinese middle-aged and older adults: data from China health and retirement longitudinal study (CHARLS)

Provisionally accepted
Qiong Lu Qiong Lu 1*Cheng Lian Cheng Lian 2*Xinglin Chen Xinglin Chen 3
  • 1 Chinese National Academy of Arts, Beijing, China
  • 2 Xi’an No.3 Hospital, the Affiliated Hospital of Northwest University, Xi’an, China
  • 3 Other, Beijing, China

The final, formatted version of the article will be published soon.

    Abstract  Background and aims: The 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. Methods: Data 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. Results: A 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 (loglikelihood 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). Conclusion: Our 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.

    Keywords: Green space, China Health and Retirement Longitudinal Study, Aging, Stroke, cohort

    Received: 28 Apr 2024; Accepted: 04 Dec 2024.

    Copyright: © 2024 Lu, Lian and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Qiong Lu, Chinese National Academy of Arts, Beijing, China
    Cheng Lian, Xi’an No.3 Hospital, the Affiliated Hospital of Northwest University, Xi’an, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.