Trajectories of social support are associated with health outcomes and depressive symptoms among older Taiwanese adults with diabetes following hip-fracture surgery.

Abstract

This study examined trajectories of social support and their relationships with health outcomes over 2years post hip-fracture surgery for older adults with diabetes mellitus (DM). This was a secondary analysis of data derived from a clinical trial, which included 158 hip fractured older adults with DM who had completed the Medical Outcomes Study Social Support Survey at 1-, 12-, 18-, and 24-months following hospital discharge. Health outcomes for self-care, physical and nutritional status, mental health, and depression were assessed at 3-month intervals up to 24-months after hospital discharge. Trajectories of social support were derived with latent class analysis while hierarchical linear models were employed to assess the associations of social-support trajectory with health outcomes. Four social-support trajectories were derived for persons with DM following hip-fracture surgery: poor and declining (n=18, 11.4%), moderate and stable (n=29, 18.4%), high but declining (n=34, 21.5%), and high and stable (n=77, 48.7%). Relative to those in the poor and declining group, participants in the high and stable trajectory group performed better in Activities of Daily Living and quadriceps muscle power, had better mental Health-Related Quality of Life and nutritional status, and had fewer depressive symptoms. These differences persisted over the 2years following hospital discharge. These results suggest social support for persons with DM should be continually assessed following hip-fracture surgery.