Building More Comprehensive Stroke Risk Profiles Among Older Adults in the United States
Description: Stroke is a leading cause of death and disability in the United States, affecting nearly 800,000 people each year and resulting in major personal and economic costs. Many older adults remain at high risk, yet early signs often go undetected. Current stroke risk tools rely mainly on traditional factors such as high blood pressure, diabetes, cholesterol, or atrial fibrillation. While important, these measures do not fully capture early changes that appear in people’s daily lives. For example, an older adult may also experience new fatigue, mobility problems, or social isolation long before clinical measures indicate worsening health. These types of symptoms and stressors have been linked to higher risk of incident stroke. This project introduces a new approach to stroke risk prediction by integrating patient-reported outcomes (PROs) with traditional risk factors and biomarkers. PROs capture symptoms, physical and cognitive function, emotional well-being, and social experiences that may signal early neurological or functional decline. The American Heart Association has identified PROs as essential to the future of cardiovascular and stroke care because they bring patient perspectives into risk assessment, improve early detection, and support more personalized interventions. We will use advanced analytic methods, including machine learning and latent profile analysis, to identify multidimensional stroke risk profiles that combine PROs, traditional risk factors, and biomarkers. The study will use data from the Health and Retirement Study, a nationally representative longitudinal dataset of older adults. Our aims are to: (1) identify distinct stroke risk profiles that predict incident stroke over a 12-year period; (2) examine how these profiles change over time using latent transition analysis; and (3) evaluate associations between risk profiles, stroke onset, and years lived stroke-free. This study will be among the first to characterize comprehensive stroke risk profiles in older adults using PROs alongside clinical measures. Findings will support future development of practical diagnostic tools and workflow integration, including simplified algorithms, digital applications for PRO collection, and embedding profiles into electronic health records. By improving early detection and prevention, this work advances the American Heart Association’s mission to reduce stroke-related death and disability and promote longer, healthier lives.
Funder: American Heart Association
Amount: $100,000
Funding type: research
Funder scheme: Rapid Impact Research Award
Start date: 2026-04-01
End date: 2028-03-31
Investigators: Jessica Fernandez, Jessica Fernandez
Institution: NORC at the University of Chicago
Funded outputs count: 0
Funder award ID: 26RIRA1649182
OpenAlex ID: G751966494