Older adults. An 11-year longitudinal study of adult protective service use

Mark S. Lachs

85 citations0/0 files storedArchives of Internal Medicine

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Elder Abuse and Neglect Aging, Elder Care, and Social Issues Geriatric Care and Nursing Homes

Abstract

BACKGROUND: Little is known about the epidemiology of adult protective services agency (APS) utilization, the state entities charged with assessment and advocacy for disenfranchised older adults. OBJECTIVE: To determine the prevalence of utilization by older adults and risk factors for APS. METHODS: A longitudinal study using the New Haven Established Population for Epidemiologic Studies in the Elderly population, a cohort of 2812 community-dwelling adults who were older than 65 years in 1982. The main outcome measure was referral to the state ombudsman on aging for protective services. RESULTS: Over the 11-year follow-up period, 209 cohort members (7.4%) were referred to the ombudsman 302 times as protective service cases for a community prevalence of 6.4% after adjusting for the sampling strategy of the cohort. Self-neglect was the most common indication for referral (73% of the cases). While in bivariate analyses a variety of baseline sociodemographic features, functional impairments, medical conditions, and social network factors were associated with APS use, in multivariable analysis only sociodemographic variables remained independent risk factors including low income (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.8 to 3.9), nonwhite race (OR, 2.2; 95% CI, 1.3 to 3.7), and age older than 75 years at cohort inception (OR, 1.9; 95% CI, 1.1 to 3.0). CONCLUSIONS: Prevalence of APS use by older adults is substantial, and sociodemographic features were the most compelling risk factors in our cohort. As the population ages, the number of older adults at risk for abuse, neglect, self-neglect, exploitation, and abandonment will increase; physicians will need to become familiar with APS referral pathways and mandatory reporting laws in their states.

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References

1977The CES-D Scale 1975All Our Kin: Strategies for Survival in a Black Community.1995Abuse and Neglect of Elderly Persons 1993Diagnostic and treatment guidelines on elder abuse and neglect 1994A Prospective Community‐Based Pilot Study of Risk Factors for the Investigation of Elder Mistreatment

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2005Elder Abuse and Neglect: An Overview 2011Prevalence of Self-Neglect across Gender, Race, and Socioeconomic Status: Findings from the Chicago Health and Aging Project 2012Self-neglect of the elderly. An overview 2008Self-neglect in Older Adults: a Primer for Clinicians 2009Self-Neglect and Neglect of Vulnerable Older Adults: Reexamination of Etiology 2009Is Greater Self-Neglect Severity Associated With Lower Levels of Physical Function?2008Impairment in Instrumental Activities of Daily Living and the Geriatric Syndrome of Self-Neglect 2019Elder Abuse Characteristics Based on Calls to the National Center on Elder Abuse Resource Line

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