Association between Life Satisfaction and Incident Stroke in Middle-Aged and Older Chinese Adults: A Prospective Cohort Study from the CHARLS
Year: 2026
Type: article
Study design: Observational Study
Abstract: INTRODUCTION: While conventional risk factors fail to fully explain stroke incidence, psychological well-being has emerged as a potential determinant of cerebrovascular health. The aim of this study was to investigate the prospective association between baseline life satisfaction and incident stroke among middle-aged and older Chinese adults. METHODS: About 15,225 participants aged ≥45 years were included from the China Health and Retirement Longitudinal Study (CHARLS, 2011-2020). Life satisfaction was assessed at baseline using a single-item 5-point scale. Incident stroke was self-reported in follow-up waves. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for sociodemographic factors, lifestyle behaviors, comorbidities, and depression symptoms. Subgroup analyses were performed by age, gender, comorbidities, BMI, and depression symptoms. RESULTS: Over the follow-up of 9 years, 1,296 participants (8.5%) developed stroke. Higher life satisfaction was associated with a significantly reduced risk of stroke (HR: 0.83; 95% CI: 0.72-0.95). Subgroup analyses indicated that the protective association was more pronounced among older adults, females, participants with chronic conditions (hypertension, diabetes, heart disease), overweight individuals, and those with depression symptoms. CONCLUSIONS: Higher life satisfaction was prospectively associated with a lower risk of incident stroke in middle-aged and older Chinese adults. Given the observational design and reliance on self-reported measures, these findings should be interpreted as evidence of association rather than causation. Future studies incorporating repeated assessments of well-being and clinically verified stroke outcomes are warranted.
Source: Cerebrovascular Diseases Extra
DOI: 10.1159/000552659
Authors: Xiuli Wang, Yanhong Zhan, Hongxing Chen
Language: English
Subfield: Social Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $1,350
OpenAlex ID: W7162211774
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