Perceived loss of social role, such as caring for family and friends, has been linked to worse outcomes for patients with heart failure, suggesting that social engagement should be part of their care
Older heart failure patients who feel they have lost their social role among friends and family are more likely to suffer poor clinical outcomes. This is the finding of a new study in Frontiers in Cardiovascular Medicine that has examined the specific aspects of social interaction that can lead to a poor prognosis for these patients.
"We are the first to show a close association between the loss of perceived social role and poor long-term clinical outcomes in older patients with heart failure," said Dr. Satoshi Katano, first author of this research, based at the Hospital Sapporo Medical University, Japan “Our study highlights the real need to develop a management program that includes a social approach to the care of these patients.”
Healthy aging
Social frailty has been widely identified as a risk for healthy aging.
Social fragility covers areas such as the loss of social roles, social networks and social activities.
“Recent research has shown that social frailty is present in two-thirds of older people suffering from heart failure and has been linked to worse outcomes for these patients. However, it has not been clear exactly why social fragility worsens the prognosis,” Katano explained. "To examine aspects of social frailty that may contribute to poor outcomes, we measured social frailty using the Makizako questionnaire in more than 300 heart failure patients over the age of 65 who were admitted to our hospital for care."
The Makizako questionnaire is a reliable method to assess social fragility. It asks participants five questions that assess the patient’s social support, social activities, living situation, and perceived social role. A negative answer to two or more of the five questions is an indicator of social fragility.
“We found that a patient’s perceived social role, as well as their overall social frailty, was associated with long-term adverse clinical outcomes in older patients with heart failure. Furthermore, both factors added to the likelihood of a negative prognosis,” Katano reported.
He continues: “Our study followed patients for three years after their admission to hospital, which is much longer than previous studies that have only followed patients for up to one year. “This allowed us to examine the long-term impact of social frailty on adverse clinical outcomes in older patients with heart failure.”
Social aspect of aftercare
The study was carried out in Japan, and although the researchers highlighted that social interactions may vary between different cultures, social frailty is likely to have a negative impact on the health of older heart failure patients in all societies. Therefore, Katano believes it is essential to include a social aspect in aftercare.
“The next important step is to develop programs to help older heart failure patients who are socially frail. Participation in household chores and social activities, such as participation in meaningful volunteer activities that serve to help others, may help improve social role perception in older patients with heart failure. “These lifestyle changes will help older heart failure patients live longer, healthier and more productive lives.”
