Social Frailty Linked to Worse Outcomes for Elderly Heart Failure Patients

WEDNESDAY, Dec. 28, 2022 (HealthDay News) — For elderly hospitalized heart failure patients, social frailty (SF) is associated with a composite outcome defined by all-cause death and cardiovascular events, according to a study published online Dec. 20 in Frontiers in Cardiovascular Medicine.

Ayako Watanabe, from the Sapporo Medical University Hospital in Japan, and colleagues conducted a retrospective cohort study involving 310 in-hospital heart failure patients aged 65 years and older. SF was defined using Makizako’s five questions, a self-reported questionnaire.

The researchers found that 61 percent of the patients had SF. During a mean follow-up of 1.93 ± 0.91 years, 75 patients (24 percent) had composite events. Patients with SF had a significantly higher composite event rate than those without SF in Kaplan-Meier curves. SF was independently associated with a higher composite event rate in multivariate Cox regression analyses after adjusting for prognostic markers (adjusted hazard ratio, 2.01). Composite events were independently predicted by an answer of yes to the question about not feeling helpful toward friends or family, indicating loss of the perceived social role (adjusted hazard ratio, 2.28). The continuous and net reclassification index and integrated discrimination improvement were improved with inclusion of loss of perceived social role in the baseline prognostic model (0.562 and 0.031, respectively).

“The next important step is to develop programs to help older heart failure patients who have social frailty,” a coauthor said in a statement. “Participation in domestic tasks and social activities such as engagement in meaningful volunteer activities that serve to help others, can all help to improve the perception of social role in older heart failure patients.”

Abstract/Full Text