Elder Abuse and Mortality: The Role of Psychological and Social Wellbeing

X.Q. Dong · Melissa Andrea Simon · T. Beck · Carol J. Farran · Judith J. McCann · Carlos F. Mendes de Leon +2 more

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Elder Abuse and Neglect Intimate Partner and Family Violence Child Abuse and Trauma

Abstract

BACKGROUND: Elder abuse is a pervasive human right and public health issue. OBJECTIVES: We aimed to examine the mortality associated with elder abuse across levels of psychological and social factors. METHODS: The Chicago Health and Aging Project (CHAP) is a prospective population-based cohort study that began in 1993. A subset of these participants enrolled between 1993 and 2005 had elder abuse reported to social services agencies (n = 113). Mortality was ascertained during follow-up and with the National Death Index. Psychosocial factors (depression, social network and social engagement) were assessed during the CHAP interview. Cox proportional hazard models were used to assess the mortality of elder abuse across levels of psychosocial factors using time-varying covariate analyses. RESULTS: The median follow-up time for the cohort (n = 7,841) was 7.6 years (interquartile range 3.8-12.4 years). In multivariate analyses, those with highest (hazard ratio (HR) 2.60, 95% CI 1.58-4.28) and middle levels (HR 2.18, 95% CI 1.19-3.99) of depressive symptoms had an increased mortality risk associated with elder abuse. For social network, those with lowest (HR 2.50, 95% CI 1.62-3.87) and middle levels (HR 2.65, 95% CI 1.52-4.60) of social network had increased mortality risk associated with elder abuse. For social engagement, those with lowest (HR 2.32, 95% CI 1.47-3.68) and middle levels (HR 2.59, 95% CI 1.65-5.45) of social engagement had increased mortality risk associated with elder abuse. Among those with lowest levels of depressive symptoms, highest levels of social network and social engagement, there was no significant effect of reported or confirmed elder abuse on mortality risk. CONCLUSION: Mortality risk associated with elder abuse was most prominent among those with higher levels of depressive symptoms and lower levels of social network and social engagement.

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References

1977The CES-D Scale 2015Older Adults' Reasons for Using Technology while Aging in Place 2002The world report on violence and health 1993Two Shorter Forms of the CES-D Depression Symptoms Index 1993Elder Abuse 2013Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America 2008Elder Mistreatment in the United States: Prevalence Estimates From a Nationally Representative Study 2009Elder Self-neglect and Abuse and Mortality Risk in a Community-Dwelling Population

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2014A Systematic Review of Prevalence and Risk Factors for Elder Abuse in Asia 2017The National Elder Mistreatment Study: An 8-year longitudinal study of outcomes 2016Elder mistreatment predicts later physical and psychological health: Results from a national longitudinal study 2011Association of Cognitive Function and Risk for Elder Abuse in a Community-Dwelling Population 2018Identifying and Initiating Intervention for Elder Abuse and Neglect in the Emergency Department

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