Older heart failure patients who feel that they have lost their social role amongst 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 long-term poor clinical outcomes in older heart failure patients," said Dr. Satoshi Katano, first author of this research, based at Sapporo Medical University Hospital, Sapporo, 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 to healthy aging. Social frailty 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 that suffer heart failure, and it has been linked to worse outcomes for these patients. However, it hasn't been clear exactly why social frailty makes the prognosis worse," explained Katano. "To examine the aspects of social frailty that may contribute to poor outcomes, we measured social frailty using the Makizako questionnaire in over 300 heart failure patients over the age of 65 that were admitted to our hospital for care."

The Makizako questionnaire is a trusted method of assessing social frailty. It asks participants five questions that evaluate the patient's social support, social activities, living situation, and perceived social role. A negative response to two or more of the five questions is an indicator of social frailty.

"We found that a patient's perceived social role, as well as their social frailty as a whole, was associated with long-term adverse clinical outcomes in older heart failure patients. In addition, both of these factors added to the likelihood of a negative prognosis," reported Katano.

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 up to a year. This enabled us to examine the long-term impact of social frailty on adverse clinical outcomes in older heart failure patients."

Social aspect to aftercare

The study was conducted in Japan, and while the researchers highlighted that social interactions may vary across different cultures, it is likely that social frailty will adversely impact health in older heart failure patients in all societies. Therefore, Katano believes that including a social aspect to aftercare is essential.

"The next important step is to develop programs to help older heart failure patients who have social frailty. 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. These lifestyle changes will help older heart failure patients live longer, healthier, and more productive lives."