TY - JOUR
T1 - Social Support in Older Adults With CKD
T2 - A Report From the CRIC (Chronic Renal Insufficiency Cohort) Study
AU - CRIC Study Investigators
AU - Slaven, Anne
AU - Hsu, Jesse
AU - Schelling, Jeffrey R.
AU - Navaneethan, Sankar D.
AU - Rincon-Choles, Hernan
AU - McAdams-DeMarco, Mara A.
AU - Schachere, Marlene
AU - O'Malley, Noreen
AU - Deluca, Jennifer
AU - Lustigova, Eva
AU - Wang, Xue
AU - Kusek, John
AU - Porter, Anna C.
AU - Lash, James P.
AU - Rahman, Mahboob
AU - Horwitz, Edward
N1 - Funding Information:
Anne Slaven, MSSA, Jesse Hsu, PhD, Jeffrey R. Schelling, MD, Sankar D. Navaneethan, MD, Hernan Rincon-Choles, MD, Mara A. McAdams-DeMarco, PhD, Marleen Schachere, RN, Noreen O'Malley, RN, Jennifer Deluca, Eva Lustigova, MPH, Xue Wang, MS, John Kusek, PhD, Anna C. Porter, MD, James P. Lash, MD, Mahboob Rahman, MD, and Edward Horwitz, MD; on behalf of the CRIC Study investigators. Research idea and study design: AS, JRS, SDN, HR-C, MAM-D, JK, ACP, JPL, MR, EH; data acquisition: AS, MS, NO, JD, EL; data analysis/interpretation: AS, JH, JRS, SDN, HR-C, MAM-D, JD, EL, XW, ACP, JPL, MR, EH; statistical analysis: JH, XW; supervision or mentorship: JRS, JK, JPL, MR. Each author contributed important intellectual content during manuscript drafting or revision and accepts accountability for the overall work by ensuring that questions pertaining to the accuracy or integrity of any portion of the work are appropriately investigated and resolved. Funding for the CRIC Study was obtained under a cooperative agreement from National Institute of Diabetes and Digestive and Kidney Diseases (U01DK060990, U01DK060984, U01DK061022, U01DK061021, U01DK061028, U01DK060980, U01DK060963, and U01DK060902). In addition, this work was supported in part by the Perelman School of Medicine at the University of Pennsylvania Clinical and Translational Science Award National Institutes of Health (NIH)/National Center for Advancing Translational Sciences (NCATS) UL1TR000003, Johns Hopkins University UL1 TR-000424, University of Maryland General Clinical Research Center M01 RR-16500, Clinical and Translational Science Collaborative of Cleveland, UL1TR000439 from the NCATS component of the NIH and NIH Roadmap for Medical Research, Michigan Institute for Clinical and Health Research (MICHR) UL1TR000433, University of Illinois at Chicago Clinical and Translational Science Awards UL1RR029879, Tulane COBRE for Clinical and Translational Research in Cardiometabolic Diseases P20 GM109036, Kaiser Permanente NIH/National Center for Research Resources UCSF-CTSI UL1 RR-024131. R01-DK072231 (Dr Lash), K24-DK092290 (Dr Lash). The authors declare that they have no relevant financial interests. Received November 17, 2020. Evaluated by 2 external peer reviewers, with direct editorial input by the Statistical Editor and the Editor-in-Chief. Accepted in revised form April 18, 2021.
Funding Information:
Funding for the CRIC Study was obtained under a cooperative agreement from National Institute of Diabetes and Digestive and Kidney Diseases (U01DK060990, U01DK060984, U01DK061022, U01DK061021, U01DK061028, U01DK060980, U01DK060963, and U01DK060902). In addition, this work was supported in part by the Perelman School of Medicine at the University of Pennsylvania Clinical and Translational Science Award National Institutes of Health (NIH)/ National Center for Advancing Translational Sciences (NCATS) UL1TR000003, Johns Hopkins University UL1 TR-000424, University of Maryland General Clinical Research Center M01 RR-16500, Clinical and Translational Science Collaborative of Cleveland , UL1TR000439 from the NCATS component of the NIH and NIH Roadmap for Medical Research, Michigan Institute for Clinical and Health Research (MICHR) UL1TR000433, University of Illinois at Chicago Clinical and Translational Science Awards UL1RR029879, Tulane COBRE for Clinical and Translational Research in Cardiometabolic Diseases P20 GM109036, Kaiser Permanente NIH/National Center for Research Resources UCSF-CTSI UL1 RR-024131. R01-DK072231 (Dr Lash), K24-DK092290 (Dr Lash).
Publisher Copyright:
© 2021 The Authors
PY - 2021/9/1
Y1 - 2021/9/1
N2 - Rationale & Objective: Social support in older adults with chronic kidney disease (CKD) is a potentially modifiable factor that may affect important clinical outcomes such as health-related quality of life, 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 health-related quality of life, 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 65 years with CKD enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study. Exposure: Social support (Lubben Social Network Scale [LSNS]). Outcomes(s): Health-related quality of life (Kidney Disease Quality of Life-36), cognitive function (Modified Mini-Mental State Examination, Trail Making Test A & B, and Buschke Selective Reminder Tests), and frailty (modified Fried frailty criteria). Analytic Approach: Multivariable, linear, and logistic regression to determine the association between social support and health-related quality of life, cognitive function, and frailty. Results: Low social support, defined as LSNS score < 12, was present in 22% of participants. On multivariable analysis, higher social support was associated with higher health-related quality of life (β coefficient per 1-SD increase in LSNS score; burden subscale, 2.57 (95% CI, 1.57-3.56); effects subscale, 2.21 (95% CI, 1.52-2.9); symptoms subscale, 1.64 (95% CI, 0.88-2.41); mental health composite subscale, 1.91 (95% CI, 1.40-2.43); and physical health composite score, 0.64 (95% CI, 0.03-1.24)). Higher social support was associated with better cognitive function (β coefficient per 1-SD increase in LSNS score; Modified Mini-Mental State Examination, 0.81 (95% CI, 0.44 to 1.19); Trail Making Test A & B, −2.53 (95% CI, −4.29 to −0.76) and −6.53 (95% CI, −10.07 to −2.99), respectively; Buschke Selective Reminder Test 1, 2, and 3, 0.19 (95% CI, 0.07 to 0.30); 1.59 (95% CI, 0.96 to 2.22); and 0.40 (95% CI, 0.23 to 0.56), respectively. Higher social support was associated with higher likelihood of being nonfrail (OR, 1.77; 95% CI per 1-SD higher LSNS score, 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 health-related quality of life and cognitive function and less frailty.
AB - Rationale & Objective: Social support in older adults with chronic kidney disease (CKD) is a potentially modifiable factor that may affect important clinical outcomes such as health-related quality of life, 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 health-related quality of life, 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 65 years with CKD enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study. Exposure: Social support (Lubben Social Network Scale [LSNS]). Outcomes(s): Health-related quality of life (Kidney Disease Quality of Life-36), cognitive function (Modified Mini-Mental State Examination, Trail Making Test A & B, and Buschke Selective Reminder Tests), and frailty (modified Fried frailty criteria). Analytic Approach: Multivariable, linear, and logistic regression to determine the association between social support and health-related quality of life, cognitive function, and frailty. Results: Low social support, defined as LSNS score < 12, was present in 22% of participants. On multivariable analysis, higher social support was associated with higher health-related quality of life (β coefficient per 1-SD increase in LSNS score; burden subscale, 2.57 (95% CI, 1.57-3.56); effects subscale, 2.21 (95% CI, 1.52-2.9); symptoms subscale, 1.64 (95% CI, 0.88-2.41); mental health composite subscale, 1.91 (95% CI, 1.40-2.43); and physical health composite score, 0.64 (95% CI, 0.03-1.24)). Higher social support was associated with better cognitive function (β coefficient per 1-SD increase in LSNS score; Modified Mini-Mental State Examination, 0.81 (95% CI, 0.44 to 1.19); Trail Making Test A & B, −2.53 (95% CI, −4.29 to −0.76) and −6.53 (95% CI, −10.07 to −2.99), respectively; Buschke Selective Reminder Test 1, 2, and 3, 0.19 (95% CI, 0.07 to 0.30); 1.59 (95% CI, 0.96 to 2.22); and 0.40 (95% CI, 0.23 to 0.56), respectively. Higher social support was associated with higher likelihood of being nonfrail (OR, 1.77; 95% CI per 1-SD higher LSNS score, 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 health-related quality of life and cognitive function and less frailty.
KW - Social support
KW - chronic kidney disease
KW - cognitive function
KW - frailty
KW - quality of life
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U2 - 10.1016/j.xkme.2021.04.025
DO - 10.1016/j.xkme.2021.04.025
M3 - Article
C2 - 34693258
AN - SCOPUS:85122744095
SN - 2590-0595
VL - 3
SP - 776-784.e1
JO - Kidney Medicine
JF - Kidney Medicine
IS - 5
ER -