Social Support in Older Adults With CKD: A Report From the CRIC (Chronic Renal Insufficiency Cohort) Study

Abstract Rationale and Objective Social support in older adults with chronic kidney disease (CKD) is a potentially modifiable factor that may impact important clinical outcomes such as health-related quality of life (HRQOL), cognitive function, and frailty. However, limited data about the effects of social support in older patients with non-dialysis-dependent CKD exist. Our objective was to evaluate the association of social support with HRQOL, cognitive function, and frailty in older adults with CKD. Study Design Cross sectional analysis of a prospective, cohort study Setting & Population 1,851 participants older than age 65 with CKD enrolled in the Chronic Renal Insufficiency Cohort (CRIC) study Exposure Social support (Lubben Social Network Score [LSNS]) Outcomes(s) Health-related quality of life (Kidney Disease Quality of Life-36), cognitive function (Modified Mini-Mental State Exam [MMSE], Trail Making Test AB burden subscale 2.57 (1.57-3.56); effects subscale 2.21 (1.52-2.9); symptoms subscale 1.64 (0.88-2.41); mental health composite subscale 1.91 (1.40-2.43); and physical health composite score 0.64 (0.03-1.24)). Higher social support was associated with better cognitive function (s coefficient (95%CI) per 1 SD increase LSNS; MMSE 0.81 (0.44-1.19); Trail Making Test A and B -2.53 (-4.29, -0.76) and -6.53 (-10.07, -2.99) respectively; Buschke Selective Reminder Test 1, 2, and 3 0.19(0.07-0.30); 1.59(0.96-2.22); and 0.40(0.23-0.56) respectively). Higher social support was associated with a higher likelihood of being non-frail (OR, 95% CI per SD higher LSNS, 1.77, 1.24-2.53). Limitations Conclusions about causality cannot be drawn from an observational, cross-sectional study Conclusions In older patients with CKD, higher social support was associated with higher HRQOL and cognitive function, and less frailty.