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. 2025 Jul 22:12:1639935.
doi: 10.3389/fmed.2025.1639935. eCollection 2025.

Association between social frailty and quality of life in older patients with chronic heart failure: sequential multiple mediating effects of family insufficiency and social networks

Junting Huang  1 , Xiaobo Liu  2 , Duolao Wang  3 , Xiaorong Luan  4 , Wanxia Yao  5
Affiliations

Association between social frailty and quality of life in older patients with chronic heart failure: sequential multiple mediating effects of family insufficiency and social networks

Junting Huang et al. Front Med (Lausanne). .

Abstract

Background and objectives: Older patients with chronic heart failure have severe somatic symptoms, which lead to high levels of social frailty and loss of quality of life. Understanding the demographic and disease factors of quality of life and its relationship with social frailty is beneficial to overall health for older patients with chronic heart failure. This study aims to explore the relationship between social frailty and quality of life in older patients with chronic heart failure and to verify whether family insufficiency and social networks moderate this relationship.

Methods: A multi-centre cross-sectional study was conducted on 443 older patients with chronic heart failure from three tertiary hospitals in China. The study questionnaire included a general information questionnaire, the HALFT scale (social frailty), the Family APGAR Index (family insufficiency), the LSNS-6 (social networks), and the MLHFQ (quality of life). Hierarchical regression analysis was used to assess the factors influencing quality of life; the SPSS PROCESS Marco Plug-in was employed to conduct mediation analysis.

Results: The results showed that age, the number of hospitalizations, and NYHA classification influenced the quality of life in older patients with chronic heart failure. Social frailty, family insufficiency, and social networks were related, and family insufficiency and social networks mediated the relationship between social frailty and quality of life, with mediating effect sizes of 25.87, 99.5 and 58.97%, respectively.

Conclusion: This study shows that high levels of social frailty are associated with reduced quality of life in older patients with chronic heart failure. Decreasing family insufficiency and extending social networks help alleviate social frailty's adverse effects on the quality of life in older patients with chronic heart failure.

Keywords: family function; heart failure; quality of life; social frailty; social networks.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The chain-mediating model of family insufficiency and social networks between social frailty and quality of life. c = total effect of social frailty on quality of life. c’ = direct effect of social frailty on quality of life. a1*b1 = indirect effect of social frailty on quality of life via family insufficiency. a2*b2 = indirect effect of social frailty on quality of life via social networks. a1*d21*b1 = indirect effect of social frailty on quality of life via family insufficiency and social networks. Total effect (c) = direct effect (c’) + indirect effect (a1*b1) + indirect effect (a2*b2) + indirect effect (a1*d21*b1).
Figure 2
Figure 2
The flowchart process of participant recruitment.
See this image and copyright information in PMC

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References

    1. Abovich A, Matasic DS, Cardoso R, Ndumele CE, Blumenthal RS, Blankstein R, et al. The AHA/ACC/HFSA 2022 heart failure guidelines: changing the focus to heart failure prevention. Am J Prev Cardiol. (2023) 15:100527. doi: 10.1016/j.ajpc.2023.100527, PMID: - DOI - PMC - PubMed
    1. Hollenberg SM, Stevenson LW, Ahmad T, Bozkurt B, Butler J, Davis LL, et al. 2024 ACC expert consensus decision pathway on clinical assessment, management, and trajectory of patients hospitalized with heart failure focused update: a report of the American College of Cardiology solution set oversight committee. J Am Coll Cardiol. (2024) 84:1241–67. - PubMed
    1. Hu SS. Heart failure in China: epidemiology and current management. J Geriatr Cardiol. (2024) 21:631–41. doi: 10.26599/1671-5411.2024.06.008, PMID: - DOI - PMC - PubMed
    1. Aïdoud A, Gana W, Poitau F, Debacq C, Leroy V, Nkodo JA, et al. High prevalence of geriatric conditions among older adults with cardiovascular disease. J Am Heart Assoc. (2023) 12:e026850. doi: 10.1161/JAHA.122.026850, PMID: - DOI - PMC - PubMed
    1. The World Health Organization quality of life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med. (1995) 41:1403–9. doi: 10.1016/0277-9536(95)00112-K, PMID: - DOI - PubMed

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