Social Support and Clinical Outcomes Among Older Adult Men and Women in the Chronic Renal Insufficiency Cohort.

BACKGROUND

Social support is an important psychosocial determinant of health, but its association with clinical outcomes among older adults with non-dialysis-dependent CKD remains incompletely characterized. We examined associations between social support and clinical outcomes among older adults with CKD and evaluated whether these associations differed by sex.

METHODS

We analyzed data from the Chronic Renal Insufficiency Cohort Study among participants aged 65 years and older who completed the Lubben Social Network Scale-6 between 2013 and 2018. Low social support was defined as a score <12. Participants were followed until death, withdrawal, or October 2024. Multivariable-adjusted negative binomial regression and Cox proportional hazards models were used to examine associations between social support and hospitalization, all-cause mortality, and CKD progression (≥50% decline in estimated glomerular filtration rate or kidney failure). Effect modification by sex, age, and race and ethnicity was evaluated.

RESULTS

Among 2,616 participants (mean age, 71±5 years; 43% women), 23% had low social support. Higher social support was associated with lower mortality risk (hazard ratio, 0.83; 95% confidence interval (CI), 0.71-0.98). This association was significant among women, Hispanic participants, and adults aged ≥70 years. Higher social support was not associated with hospitalization risk in the overall cohort (incidence rate ratio, 0.92; 95% CI, 0.82-1.03) but was associated with lower hospitalization risk among women and older adults, with significant effect modification by sex (P-interaction=0.01). Support from friends, but not family, was associated with lower mortality risk. Social support was not associated with CKD progression.

CONCLUSIONS

Among older adults with non-dialysis-dependent CKD, higher social support was associated with lower mortality risk, while lower hospitalization risk was observed among women and older adults aged ≥70 years, with stronger protective associations observed among women.