Medical Implications of Elder Abuse: Self-Neglect

Ortíz, Carlos; Burnett, Jason; Flores, David V.; Halphen, John M.; Dyer, Carmel B.

doi:10.1016/j.cger.2014.08.008

Cited by 21 publications

(10 citation statements)

References 57 publications

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“…Higher levels of household disorder predicted an increased risk of mortality, an association that was explained mainly by the presence of frailty. This result supports previous research reporting that frailty both increases the risk of all-cause mortality (Chang & Lin, 2015; Kulama et al, 2014) and complicates home upkeep (Lee et al, 2016; Peace et al, 2011; Reyes-Ortiz, Burnett, Flores, Halphen, & Dyer, 2014). Results also reinforce the importance of distinguishing between home and body as contexts of disorder, a seldom-drawn distinction in much existing research (but see Burnett et al, 2014 for an important exception).…”

Section: Discussionsupporting

confidence: 91%

Disorderly Households, Self-Presentation, and Mortality: Evidence From a National Study of Older Adults

2017

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This article examines whether disorderly household conditions and bodily self-presentation predict mortality, above and beyond four sets of variables conceptually linked to both death and disorder. Data come from 2005/2006 and 2010/2011 waves of the National Social Life, Health, and Aging Project. We used naturalistic observation of respondents' homes and bodies, along with a diverse range of additional covariates, to predict probability of death. Older adults living in disorderly households were at highest risk of death over 5 years, primarily because they confronted high levels of frailty. Disorderly bodily self-presentation was also related to mortality risk, but this association could be only partially explained by demographic factors, health conditions, frailty, and low social connectedness. Findings suggest that disorder in the residential context-dress and hygiene in particular-is a strong predictor of mortality. Support providers should be mindful of changes in bodily presentation among community-dwelling older adults.

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Section: Discussionsupporting

confidence: 91%

Disorderly Households, Self-Presentation, and Mortality: Evidence From a National Study of Older Adults

2017

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“…Selfneglect can result in devastating consequences for the elderly people, potentially exacerbating diseases (Braye et al, 2011), leading to higher healthcare utilization (Franzini and Dyer, 2008), and even causing premature death (Dong et al, 2009). However, the etiology of self-neglect is still unclear (Reyes-Ortiz et al, 2014). The wellknown biopsychosocial path model, proposing links between health conditions and ESN development, was developed by Dyer and colleagues (2007).…”

Section: Introductionmentioning

confidence: 99%

Associations of self-neglect with quality of life in older people in rural China: a cross-sectional study

Zhao

Feng

et al. 2017

Int. Psychogeriatr.

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“…S elf-neglect is the behavior of an older person that threatens his/her own health and safety or fails to provide himself/ herself with adequate food, water, clothing, shelter, personal hygiene, medication, and safety precautions. 1 Despite the wealth of existing knowledge about associated factors of prevalent self-neglect in sociodemographic, socioeconomic, health behaviors, medical, cognitive, physical, social, and psychological aspects, [2][3][4][5][6][7][8][9] the etiology of incident self-neglect is largely unknown. 5,10-13 A lack of systematic and longitudinal examination of antecedents of self-neglect has hindered the prevention and intervention development.…”

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confidence: 99%

A Vulnerability Risk Index of Self‐Neglect in a Community‐Dwelling Older Population

Bei

Hoover

Beck

et al. 2019

J American Geriatrics Society

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BACKGROUND The only way to systematically screen for self‐neglect among older adults is through in‐home observations, which are often difficult and unfeasible for healthcare providers. To fill this gap, we need a robust and efficient prognostication tool to better treat and prevent self‐neglect among older adults. OBJECTIVES To develop a predictive index that can be used to assess risk prognostication of the onset of self‐neglect among community‐dwelling older populations. DESIGN Two waves of longitudinal data from the Chicago Health and Aging Project (CHAP), collected during 2008 to 2012 with approximately 3‐year follow‐up intervals. SETTING Non‐Hispanic black or non‐Hispanic white community‐dwelling older adults in three adjacent neighborhoods in Chicago, IL. PARTICIPANTS A total of 2885 individuals who were participants of the CHAP study. MEASUREMENTS The main outcomes are incident self‐neglect cases. A total of 86 potential predictors were considered in the domains of sociodemographic and socioeconomic, general well‐being, health behavior, medical health, medicine/healthcare, cognitive function, physical well‐being, social well‐being, and psychological well‐being. RESULTS The 3‐year self‐neglect incidence rate is 241 (8.4%). A 10‐item predictive model (with a c‐statistic of 0.76) was developed using stepwise selection in multivariable logistical regression models. After corrections of overfitting by validating in 100 bootstrapping samples, the predictive accuracy of the model dropped to 0.71, suggesting at least moderate overfitting. A point‐based risk index was developed based on parameter estimates of each predictive factor in the final logistic model. The index has an area under the receiver operating characteristic curve of 0.76. CONCLUSION The study developed an efficient index with good predictive ability of self‐neglect. Further external validation and impact studies are necessary before practitioners can apply this index to determine risk of self‐neglect among other community aging populations. J Am Geriatr Soc 68:809–816, 2020

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Medical Implications of Elder Abuse: Self-Neglect

Cited by 21 publications

References 57 publications

Disorderly Households, Self-Presentation, and Mortality: Evidence From a National Study of Older Adults

Disorderly Households, Self-Presentation, and Mortality: Evidence From a National Study of Older Adults

Associations of self-neglect with quality of life in older people in rural China: a cross-sectional study

A Vulnerability Risk Index of Self‐Neglect in a Community‐Dwelling Older Population

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