# Public health implications of lifestyle and sociocultural determinants of stroke risk and serum biochemical markers among older adults in northern Thailand

## TL;DR

This study explores how lifestyle and cultural factors in northern Thailand affect stroke risk and blood markers in older adults.

## Contribution

It identifies specific lifestyle and socio-cultural influences on stroke risk and serum biomarkers in an aging Thai population.

## Key findings

- Stroke risk is significantly linked to age, hypertension, education level, and metabolic factors like glucose and cholesterol.
- Dietary habits predict specific serum biomarkers, such as fat intake increasing cholesterol and sweet intake raising glucose levels.
- Educational disparities may contribute to stroke vulnerability through health literacy differences.

## Abstract

Thailand is entering a fully aging society. The northern region has a unique socio-cultural landscape that may influence the risk of stroke. However, evidence on the interplay between lifestyle and socio-cultural factors and serum biomarkers in Thai elderly remains limited. The study aimed to investigate the correlation between socio-demographic, lifestyle, socio-cultural factors and stroke risk, as well as to evaluate the association between these factors and serum biochemical markers in elderly individuals residing in northern Thailand.

A cross-sectional analysis was conducted among older adults (aged 60 years and older) with chronic conditions (n = 318). The Thai cardiovascular disease (CVD) risk assessment tool was used to stratify stroke risk into two groups. Data included demographics, education, occupation, health behaviors (diet: fatty, salty, sweet), clinical factors, and laboratory indicators (FBS, lipid profile, homocysteine). Univariate and multivariate logistic regression were used to assess stroke risk, and hierarchical linear regression (Models 1–3) was used to examine associations with serum biomarkers.

Of the 318 elderly participants, 229 (72%) were classified as at risk for stroke. Stroke risk was significantly associated with older age (70–79 years), hypertension, lower educational attainment, presence of underlying medical conditions, fasting glucose levels in the diabetic range, high total cholesterol, and elevated homocysteine levels. In the linear regression analysis, age was inversely associated with fasting glucose and cholesterol levels. Fat intake predicted higher cholesterol levels, sweet intake predicted higher fasting glucose levels, and salt intake predicted elevated homocysteine levels.

These findings indicate that stroke risk among older adults in northern Thailand is influenced by biological aging and metabolic dysregulation. Educational disparities, possibly reflecting differences in health literacy, may further contribute to stroke vulnerability. Blood pressure, blood glucose, lipid parameters, and homocysteine levels highlight the role of interconnected metabolic pathways in shaping cerebrovascular risk.