Perceived social support following myocardial infarction and long-term development of frailty

Frailty is a multidimensional geriatric syndrome that indicates increasing vulnerability and decreasing resistance to stressors. Social support (SS) is linked both to cardiovascular disease and to frailty. However, few cohort studies evaluated SS as a potential predictor of frailty, and none involved coronary disease populations. The aim of this study was to evaluate the role of perceived SS (PSS) - a specific component of SS - in the prediction of frailty development in myocardial infarction (MI) survivors, controlling for other psychosocial risk factors.

A cohort of 558 patients aged ≤65 years, admitted for first-ever MI to hospitals in central Israel, was studied. PSS and other clinical and sociodemographic variables were assessed at baseline. Frailty was assessed via a frailty index of deficit accumulation 10-13 years later. Logistic regression models were constructed to assess the odds ratios (OR) for frailty associated with PSS as well as other covariates.

At last follow-up, 154 (28%) met the criteria for frailty. In the logistic regression models, higher PSS level was associated with lower frailty risk (unadjusted OR = 0.63, 95%CI 0.53-0.76; multivariable-adjusted OR = 0.80, 95%CI 0.64-0.98). Below average family income, poor self-rated health and higher depression scores were all associated with the development of frailty, in both the unadjusted and adjusted models.

PSS predicts frailty development post-MI, which has important implications for prognosis and healthcare use.