More and more effective treatments. Technologies for monitoring and assistance, even remotely. In the challenge to heart failure, science has made strides that were unthinkable until recently. But for those who suffer from it, it is not only the control of the contraction capacity of the heart, the tailor-made therapy, the reduction of the risk of edema that limit the ability to move and cause breathing difficulties.
Quality of life is essential. And it is essential to have an integral role in society, in the family. Because losing one’s dimension in the world, perhaps closing oneself in a bubble of loneliness and sadness, can be very serious. Enough to weigh on cardiovascular health.
Seniors looking for a role
Older people who suffer from heart failure and feel that they no longer have their role in society would be at greater risk of having much worse clinical outcomes, compared to their peers who are still an integral part of their world. To report it is an original Japanese research appeared on Frontiers in Cardiovascular Medicine, which considered the specific aspects of social interaction and their effects on circulation health. The social dimension, according to the survey, would be a key to psychophysical well-being capable of having a heavy impact on the health sector. so much to induce, if the necessary attention is not paid to this aspect, on the prognosis itself of the decompensation.
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The unbearable weight of social fragility
The study was conducted by a team coordinated by Satoshi Katanoof Sapporo University on more than 300 people over the age of 65 with heart failure. Their health conditions were observed for three years, obviously within the center where the team operates. The choice of the population is not accidental: there are researches that show how the loss of a social role, of interconnections with friends and of social activities (all aspects potentially linked to the disease), would be present in about two out of three elderly people who with a “tired” heart.
The investigation
A special questionnaire, called Makizako, was used for the survey. It asks participants five questions that assess the patient’s social support, social activities, living situation, and perceived social role. A negative answer to two or more of the five questions according to this approach would be an indicator of social fragility. Results? As Katano explains the researchers “we found that the patient’s perceived social role and social frailty as a whole are associated with long-term negative clinical outcomes in elderly patients with heart failure.”
In short, the research shows for the first time a close association between the loss of the perceived social role and unsatisfactory clinical outcomes for these patients. In practice, it is as if cardiovascular health were closely linked to psychological well-being and inclusion in one’s social environment. In the absence of this aspect, the actual health situation would also tend to worsen significantly.
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Tailored programs against loneliness
Let me be clear: every country and every culture has different prerogatives in terms of social involvement of the elderly, especially if with chronic pathologies such as decompensation. It is therefore not possible to immediately transfer the results that have emerged to other anthropological and social realities, with a role of the elderly that appears profoundly dissimilar from that of oriental culture. But at the basis of the situation there is certainly a widespread reality: counteracting loneliness, preventing the person from feeling alone and above all useless and not being listened to, appears to be fundamental for improving not only the psychological aspects but also the clinical outcomes of those suffering from chronic cardiovascular diseases such as decompensation.
The psychological aspect
The proposal of the Japanese scholars is therefore clear: it is necessary to prepare programs that consider not only the classic diagnostic tests to monitor the decompensation, but also real tailor-made initiatives that provide for these patients to participate in domestic tasks and social activities such as Engagement in meaningful volunteer activities that serve to help others can all contribute to improving perceptions of social role in older patients with heart failure. “These lifestyle changes will help older heart failure patients live longer, healthier and more productive lives,” Katano said.
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For the elderly, therefore, isolation should be avoided. And not just if you suffer from heart failure. The feeling of loneliness could almost represent an additional cardiovascular risk factor, in addition to the classic elements such as high blood pressure, overweight, hypercholesterolemia and diabetes. Even for an elderly person in good health, isolation would increase by 66% the probability of suffering a cardiovascular event such as heart attack
Social support
In the presence of a lack of social support, then, the risk would increase by 50%, obviously compared to those who instead have a socially “warm” and engaging environment that offers stimuli and above all company. To signal the importance of these social approaches is a research some time ago coordinated by Rosanne Freak-Poli of Monash University, which appeared in BMC Geriatrics. The study examined nearly 11,500 people over the age of 70 of both sexes who were followed on average for just under five years. Final summary: paying attention to the psyche and social life protects the heart (bruised or not) of the elderly. Let’s not forget that.
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