“Won't You Be My Neighbor?”

Abstract

Accumulating evidence from numerous epidemiological and pre-clinical studies has suggested that social factors can have a profound influence on physical and mental health1–7. People with high levels of social support or large social networks exhibit lower all-cause mortality and more rapid and extensive functional and cognitive recovery after a wide variety of pathological insults, including stroke1–6. In contrast, social isolation is associated with increased mortality and morbidity in patients with established vascular disease2, 4. Individuals who report lack of social support or isolation have an increased incidence of recurrent stroke, poorer recovery, and greater functional decline over the 5 years following a stroke compared to individuals with social support3. Low social support is associated with increased vascular risk even after controlling for common risk factors such as age, education, obesity, exercise, smoking, and drinking2, 3. Attesting to the importance of behavioral factors in stroke outcome is that these same effects can be modeled in animals5, 8. Social interaction improves behavioral deficits and reduces histological damage after experimental stroke, whereas isolation, even for as little as a week, enhances ischemic damage1, 5. The work by Karelina et al in this issue of Stroke move us closer to

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