Abstract
<title>Abstract</title> <p> <bold>Background</bold> Chronic heart failure (CHF) frequently severely restricts social networks and damages social roles in older adults. This study aimed to identify the latent profiles of social integration among elderly patients with CHF and to examine their multi-level influencing factors based on the biopsychosocial model. <bold>Methods</bold> Using a convenience sampling design, a cross-sectional survey was conducted from October 2025 to April 2026 among elderly patients with CHF in a tertiary Grade-A hospital in Guilin, Guangxi. Questionnaires included a General Information Questionnaire, the Social Integration Scale (SCS), the Type D Personality Scale (DS-14), and the WHO Integrated Care for Older People (ICOPE) screening tool. Latent profile analysis (LPA) was used to determine optimal behavioral phenotypes, and multivariable multinomial logistic regression was performed to identify independent predictors. <bold>Results</bold> A total of 309 patients effectively completed the survey (response rate = 92.2%). The average social integration score was(17.79 ± 6.39), indicating a medium-to-low level. Social integration was successfully classified into three distinct sub-populations : Profile 1: "Low integration-deep social withdrawal" (33.01%); Profile 2: "High integration-functional basic adaptation" (37.54%) ; and Profile 3: "Medium integration-superficial etiquette maintenance" (29.45%). Multivariable logistic regression revealed that lower intrinsic capacity, presence of Type D personality, higher annual readmission frequency, fewer children, urban residence, longer disease duration, and advanced NYHA functional class were independent risk factors for severe social alienation (all P < 0.05). <bold>Conclusions</bold> Social integration among elderly CHF patients presents pronounced group heterogeneity. Clinical practitioners should transition from an aggregate scoring approach to a person-centered classification strategy, applying stepped and proactive care pathways to prevent irreversible social isolation. </p>