Perceived Social Isolation and Outcomes in Patients With Heart Failure

Manemann, Sheila M.; Chamberlain, Alanna M.; Roger, Véronique L.; Griffin, Joan M.; Boyd, Cynthia M.; Cudjoe, Thomas; Jensen, Daniel; Weston, Susan A.; Fabbri, Matteo; Jiang, Ruoxiang; Rutten, Lila J. Finney

doi:10.1161/jaha.117.008069

Cited by 85 publications

(94 citation statements)

References 27 publications

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“…There was also evidence of increased risk for socially isolated patients, indicated by significant associations between both living alone and being unpartnered with depression at late convalescence, as well as through the decision tree analysis. Again this is consistent with earlier research that has demonstrated that social isolation is associated with poor mental health including depression and suicide (Cheok et al, 2003;Iliffe et al, 2007;Manemann et al, 2018). Similarly, lack of marital support has been shown to significant predict adverse outcomes (Compare et al, 2013).…”

Section: Discussionsupporting

confidence: 89%

Anxiety and Depression After a Cardiac Event: Prevalence and Predictors

et al. 2020

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Introduction: Patients who are anxious or depressed after an acute cardiac event are at increased risk of a subsequent event and premature death. It is therefore important to identify these patients early in order to initiate supportive or even preventive measures. In the present study, we report on the prevalence of anxiety and depression during the first 12 months after an acute cardiac event, and the patient characteristics predictive of increased anxiety and depression risk in early and late convalescence. Methods: We recruited a sample of 911 patients with acute myocardial infarction (AMI), acute coronary syndrome (ACS), and/or unstable angina (UA), and/or undergoing coronary artery bypass graft surgery (CABGS). Patients completed the Hospital Anxiety and Depression Scale (HADS) close to the time of their event, and again during early (2-4 months post-event) and late (6-12 months post-event) convalescence. Using HADS-A and HADS-D cutoffs of 8+, prevalence rates for anxiety, depression, and comorbid anxiety and depression were determined for each timepoint. Chi-square tests and odds ratios were used to identify baseline patient characteristics associated with increased anxiety and depression risk over 12 months. Results: Anxiety rates were 43, 28, and 27% at the time of the event, early, and late convalescence. Depression rates were 22, 17, and 15%, respectively. Factors consistently associated with increased anxiety and depression risk were history of depression, financial strain, poor self-rated health, low socioeconomic status, younger age (<55 years), and smoking. Obesity, diabetes, and social isolation (living alone or being unpartnered) were identified as important albeit less significant risk factors. Neither sex nor event type were predictive of anxiety or depression. Conclusion: This large patient sample provided the opportunity to identify rates of anxiety and depression during the 12 months after a cardiac event and key patient characteristics for increased risk. These risk factors are easily identifiable at the time of the event, and could be used to guide the targeting of support programs for patients at risk.

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Section: Discussionsupporting

confidence: 89%

Anxiety and Depression After a Cardiac Event: Prevalence and Predictors

et al. 2020

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“… 50 In patients with heart failure, higher perceived loneliness was associated with more frequent ambulatory and emergency room visits and hospital admissions. 51 Vascular pathology and morbidity associated with SI/L are likely to contribute to the onset and disease course of other late-life conditions such as geriatric depression and neurocognitive disorders.…”

Section: Definitionsmentioning

confidence: 99%

Social Isolation and Loneliness in Older Adults: Review and Commentary of a National Academies Report

Donovan

Blazer

2020

The American Journal of Geriatric Psychiatry

339

190

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Highlights This article provides a comprehensive review of the recent National Academies of Science, Engineering and Medicine consensus committee report on Social Isolation and Loneliness (SI/L). The relevance specifically for mental health providers is emphasized. What is the primary question addressed by this study?What are the physical and mental health consequences of SI/L? What are the current evidence-based interventions for SI/L which can be implemented by mental health professionals? SI/L are significant public health problems and are clear risks for death, depression, anxiety, and cognitive disorders such as major cognitive impairment (dementia). The evidence based interventions by mental health professionals for SI/L are limited yet some have emerged which are promising. Health and mental healthcare professionals may be the first to identify socially isolated and lonely older adults as these older adults are at significant increased risk for serious adverse outcomes. For this reason, these professionals should know how to screen for and to initiate interventions that can be helpful.

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“…The evaluation of the social status of each AHF patient is therefore important for preventing re-admission due to HF and a poor prognosis. Several groups have systemically investigated the impact of social determinants or isolation on the prognosis of AHF patients (4-7). Lu et al reported that the marital status and living conditions were correlated with the mortality and readmission rate among African Americans with HF (5).…”

Section: Introductionmentioning

confidence: 99%

Gender Differences in the Social Determinants of the Long-term Prognosis for Severely Decompensated Acute Heart Failure in Patients over 75 Years of Age

et al. 2019

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Objective The aim of present study was to elucidate the gender differences in social determinants among patients with acute heart failure (AHF). Methods A total of 1,048 AHF patients were enrolled, and the 508 AHF patients who were ! 75 years old and the 540 patients who were <75 years old were evaluated as the elderly and non-elderly cohorts, respectively. Participants who met one of the three marital status-, offspring-, and living status-related criteria were considered socially vulnerable, and subjects were thus classified into socially vulnerable and non-socially vulnerable groups by gender in both the non-elderly and elderly cohorts. Social vulnerability was significantly more common in the elderly cohort (n=246, 48.4%) than in the non-elderly cohort (n=197, 36.5%) and significantly more common in the elderly women (n=157, 69.4%) than in the elderly men (n=89, 31.5%). Kaplan-Meier curves showed that the survival rate of the socially vulnerable group was significantly poorer than that of the non-socially vulnerable group in the elderly male cohort (p=0.010). Social vulnerability was an independent predictor of the 1,000-day mortality in the elderly male cohort (hazard ratio: 1.942, 95% confidence interval: 1.102-3.422) but not in the elderly female cohort according to a multivariate analysis. Conclusion Social vulnerability was shown to be more common in elderly female AHF patients than in elderly men, although it was associated with a poor prognosis in elderly men. Reinforcing the social structure of elderly male AHF patients might help improve their prognosis.

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Perceived Social Isolation and Outcomes in Patients With Heart Failure

Cited by 85 publications

References 27 publications

Anxiety and Depression After a Cardiac Event: Prevalence and Predictors

Anxiety and Depression After a Cardiac Event: Prevalence and Predictors

Social Isolation and Loneliness in Older Adults: Review and Commentary of a National Academies Report

Gender Differences in the Social Determinants of the Long-term Prognosis for Severely Decompensated Acute Heart Failure in Patients over 75 Years of Age

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