Elder Self‐Neglect and Hospitalization: Findings from the Chicago Health and Aging Project

XinQi Dong · Melissa Andrea Simon · Denis A. Evans

89 citations0/0 files storedJournal of the American Geriatrics Society

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Elder Abuse and Neglect Suicide and Self-Harm Studies Child Abuse and Trauma

Abstract

OBJECTIVES: To quantify the relation between reported elder self-neglect and rate of hospitalization in a community population of older adults. DESIGN: Prospective population-based study. SETTING: Geographically defined community in Chicago. PARTICIPANTS: Community dwelling older adults who participated in the Chicago Health and Aging Project. One thousand one hundred sixty-five of the 6,864 participants in the Chicago Health and Aging Project was reported to social services agency for suspected elder self-neglect. MEASUREMENTS: The primary predictor was elder self-neglect reported to social services agency. The outcome of interest was the annual rate of hospitalization, obtained from the Centers for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships. RESULTS: The average annual rate of hospitalization was 0.6 ± 1.3 for participants without elder self-neglect and 1.8 ± 3.2 for those with reported elder self-neglect. After adjusting for sociodemographic and socioeconomic characteristics, medical commorbidities, and cognitive and physical function, older adults who neglected themselves had significantly higher rate of hospitalization (rate ratio = 1.47, 95% confidence interval = 1.39-1.55). Greater severity of self-neglect (mild: standardized parameter estimate (PE) = 0.24, standard error (0.05); moderate: PE = 0.45 (0.03); severe: PE = 0.54, (0.11), all P < .001) was associated with higher annual rates of hospitalization after adjusting for the same confounders. Interaction term analyses suggest that medical conditions, cognitive impairment, and physical disability did not mediate the significant relationship between self-neglect and hospitalization. CONCLUSION: Reported elder self-neglect was associated with higher rates of hospitalization in this community population. Greater severity of self-neglect was associated with a greater rate of hospitalization.

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References

2009Prevalence and Correlates of Emotional, Physical, Sexual, and Financial Abuse and Potential Neglect in the United States: The National Elder Mistreatment Study 1995Encyclopedia of social work 2010Financial Exploitation and Psychological Mistreatment Among Older Adults: Differences Between African Americans and Non-African Americans in a Population-Based Survey 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 2002Adult Protective Service Use and Nursing Home Placement 2007Self-Neglect Among the Elderly: A Model Based on More Than 500 Patients Seen by a Geriatric Medicine Team 2005Medical Implications of Elder Abuse and Neglect

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2016Diagnosis of Elder Abuse in U.S. Emergency Departments 2012Elder Abuse and Neglect 2013Elder Abuse: Research, Practice, and Health Policy. The 2012 GSA Maxwell Pollack Award Lecture 2012Elder Self-Neglect Is Associated With Increased Risk for Elder Abuse in a Community-Dwelling Population

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