Abstract
The purpose of this study was to determine the combined effects of gender and levels of social support on 1-year functional health outcomes in older persons diagnosed with heart failure (HF). Persons ≥ 65 years of age with an acute HF exacerbation (164 females; 271 males) were enrolled and followed for a year. Participants completed baseline and 12-month questionnaires containing clinical and demographic descriptive information and validated self-report measures of: (1) physical functioning (Medical Outcome Study [MOS] SF12 and Kansas City Cardiomyopathy Questionnaire [KCCQ]) and (2) social support (MOS- Social Support Survey). Women were more likely to be single, widowed or divorced, living alone and earning less annual income. At baseline, women reported significantly lower support and physical function scores. However, at 1 year there were no significant gender differences in the proportion of men or women who experienced clinically meaningful functional decline or death across the year of follow-up. In multivariable modeling, men with lower levels of social support were more likely to experience functional decline. This was not the case for women. Our findings suggest that gender-directed strategies to promote optimization of function for both men and women living with HF in their community are warranted.
Highlights
Heart failure (HF) is a common chronic cardiovascular disease that typically presents as episodes of acute exacerbation combined with periods of clinical stability
We considered the lost-to-followup group as potentially different from those who completed, and we included a separate classification for this group in relevant analyses
This study reports on the gender differences in social support and its corresponding relationship to both general and disease-specific adverse functional outcomes in the HF population
Summary
Heart failure (HF) is a common chronic cardiovascular disease that typically presents as episodes of acute exacerbation combined with periods of clinical stability. Due to its chronic nature, patients and their caregivers assume much of the daily management; it is important to understand the influence of nonmedically related care factors, such as social support, on health outcomes and functionality. We know that the personal, clinical, and social profiles of persons with chronic conditions such as heart failure will vary. Older women are more likely to (a) have limited social supports, (b) be living on their own, with less financial resources, (c) not access formalized supports such as cardiac rehabilitation programs, (d) report poorer health-related quality of life, and (e) have worse physical function, in comparison to men [1,2,3]. Some postulate that social support facilitates coping and adaption and moderates the psychological and physiological consequences of illness [9, 10]
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