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.