Social Frailty in Heart Failure: Concept, Impact and Preventive Strategies

Abstract

Aims: To explore the conceptualisation of social frailty and discuss its role in shaping the disease trajectory of heart failure. Based on the discussion, recommendations on how to prevent and manage social frailty in this clinical cohort are delineated. Design: A discursive paper. Methods: This paper searched two databases, PubMed and Google Scholar, for a narrative review of the literature related to social frailty and heart failure from 2008 to 2024. Findings: By integrating the conceptualisation of social frailty from different theoretical paradigms, social frailty is a multi-domain construct that relies on a balance between the availability of environmental resources, social interactions and an individual's ability to maintain and acquire these resources to enhance their well-being. Substantial evidence showed the prognostic impact of social frailty on patient-reported, functional and clinical outcomes of patients with heart failure. The underlying mechanism is still under-investigated, but heart failure-related self-care may mediate its impact. Based on this evidence, improving social frailty may rely on a diagnostic protocol to enhance the person-centred care planning on ways to optimise the social resources to support complex self-care. Conclusion: Social frailty poses a greater risk to health outcomes in patients with heart failure. Further research is needed to explore determinants and interventions for social frailty in this population. Implications: This paper increases the awareness of social frailty in heart failure patients and provides important insights on how to combat this social determinant of poor health outcomes among this clinical cohort. A dual-purpose approach of improving social resources and self-care behaviours may have great promise in reducing their social frailty, and this postulation will need to be investigated in future research. Patient or Public Contribution: There is no involvement of patients or the public in the design or writing of this discursive paper.