["Geriatrics &Gerontology International, Volume 26, Issue 6, June 2026. ", "\nAmong older patients with stage B heart failure, the coexistence of social frailty and sarcopenia was associated with a substantially higher risk of adverse cardiovascular outcomes, whereas either condition alone was not prognostic.\n\nABSTRACT\n\nAim\nTo investigate the association between social frailty and sarcopenia and their combined effect on clinical outcomes in outpatients with stage B heart failure (HF).\n\n\nMethods\nThis post hoc analysis of the PAPRIKA‐HF study included 331 patients aged ≥ 65 years with stage B HF. Patients were stratified into three groups based on social frailty and sarcopenia. The primary outcome was a 2‐year composite of all‐cause death, myocardial infarction, and HF hospitalization.\n\n\nResults\nOf 308 patients, 189 (61%) had social frailty. Sarcopenia prevalence was higher in patients with versus without social frailty (20.6% vs. 11.8%, p = 0.04). Event rates for the composite outcome differed across groups (absence of social frailty and sarcopenia: 1.9% vs. presence of social frailty or sarcopenia: 3.0% vs. presence of both: 33.3%; log‐rank p < 0.001). In the multivariable Cox model, no significant difference existed between absence of social frailty and sarcopenia and presence of social frailty or sarcopenia (hazard ratio 2.44; 95% confidence interval 0.51–11.52; p = 0.26), while presence of both had higher risk compared with absence of both (hazard ratio 12.98; 95% confidence interval 2.46–68.50; p < 0.01).\n\n\nConclusion\nThe coexistence of social frailty and sarcopenia is associated with adverse outcomes in outpatients with stage B HF. Early identification and multidisciplinary interventions for social frailty may help improve long‐term prognosis.\n\n"]