Abstract
Introduction: Living with coronary heart disease (CHD) significantly impacts patients’ daily activities and physical exercise. Social support influences functional status and physical activity in patients with CHD. Multiple dimensions of social support may be associated with activities of daily living (ADL) and physical activity (PA) outcomes in patients with CHD. Hypothesis: Is higher perceived social support positively associated with ADLs and PA in patients who have lived with CHD for over 20 years? Methods: We analyzed data from the Heart and Soul prospective cohort study from 3-time points: 2000-2002, 2005-2007, and new data that were collected in 2022 among survivors of the original cohort. We measured social support using the Interpersonal Support Evaluation List (ISEL) with appraisal, belonging, and tangibility dimensions. Functional status was assessed using the Lawton (instrumental ADLs [IADLs]) and Katz scales (ADLs) and self-reported PA. Logistic mixed-effects models were employed, adjusting for ISEL dimensions, age, gender, socioeconomic status, ethnicity, marital status, and time. Results: Among 680 patients [(mean age at baseline 65.9 (SD10.2); 121 females (17.8%)], higher levels of appraisal (OR: 1.08; CI: 1.01-1.16) and belonging support (OR: 1.12; CI: 1.05-1.20) were significantly associated with higher IADL scores in the Lawton scale. Only belonging was significant in the Katz ADL scale (OR: 1.11; CI: 1.00-1.29). The tangible dimension was not significant in both scales. All dimensions exhibited significant positive associations with PA, with belonging support showing the strongest association (OR: 1.11; CI: 1.05-1.18) (P <.05 & 95% CI). A positive trend was observed between ADL and PA with ISEL dimensions, warranting further investigation of potential time-dependent effects. Conclusions: In this study examining 3-time points over 20 years, social support dimensions emerged as predictors of improved ADL and increased PA in patients with CHD. Results emphasize the need to foster social support as part of long-term care strategies.
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