Emotional support and survival after myocardial infarction. A prospective, population-based study of the elderly.
OBJECTIVE
To compare the survival of elderly patients hospitalized for acute myocardial infarction who have emotional support with that of patients who lack such support, while controlling for severity of disease, comorbidity, and functional status.


METHODS
A prospective, community-based cohort study.


METHODS
Two hospitals in New Haven, Connecticut.


METHODS
Men (n = 100) and women (n = 94) 65 years of age or more hospitalized for acute myocardial infarction between 1982 and 1988.


METHODS
Social support, age, gender, race, education, marital status, living arrangements, presence of depression, smoking history, weight, and physical function were assessed prospectively using questionnaires. The presence of congestive heart failure, pulmonary edema, and cardiogenic shock; the position of infarction; in-hospital complications; and history of myocardial infarction were assessed using medical records. Comorbidity was defined using an index based on the presence of eight conditions.


RESULTS
Of 194 patients, 76 (39%) died in the first 6 months after myocardial infarction. In multiple logistic regression analyses, lack of emotional support was significantly associated with 6-month mortality (odds ratio, 2.9; 95% CI, 1.2 to 6.9) after controlling for severity of myocardial infarction, comorbidity, risk factors such as smoking and hypertension, and sociodemographic factors.


CONCLUSIONS
When emotional support was assessed before myocardial infarction, it was independently related to risk for death in the subsequent 6 months.
Berkman
L F
LF
Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 06510.
Leo-Summers
L
L
Horwitz
R I
RI
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015897:Comorbidity; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000401:mortality* / Q000523:psychology*; D011446:Prospective Studies; D012044:Regression Analysis; D012944:Social Support; D015996:Survival Rate