Mortality and Disability Outcomes of Self‐Reported Elder Abuse: A 12‐Year Prospective Investigation

Schofield, Margot J.; Powers, Jennifer R.; Loxton, Deborah

doi:10.1111/jgs.12212

Cited by 120 publications

(80 citation statements)

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“…Linkages between verbal and physical abuse exposure, and increased risk of all-cause mortality among older women, have been reported in several prior studies [21,22], as has evidence of bi-directional relationships between verbal and physical abuse exposure and diminished physical and mental health [29]. A bi-directional relationship between abuse exposure and diminished physical functioning in older women [36][37][38] has also been proposed, with some prior work characterizing physical functioning as an important risk factor for verbal and/or physical abuse in this population [36][37][38], and other work suggesting that abuse among older women may degrade physical functioning, ultimately leading to disability [22].…”

Section: Introductionmentioning

confidence: 84%

“…While the disproportionate risk of young women (e.g., of childbearing age), particularly those who are pregnant, is well documented [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16], a growing empirical literature also characterizes the significant prevalence and public health implications of interpersonal abuse exposure, including verbal, physical or sexual abuse, neglect, and financial exploitation, among older, post-menopausal women [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. For example, Zink et al [33] conducted a telephone survey investigating prevalence of abuse exposure among more than 3500 women over age 55.…”

Section: Introductionmentioning

confidence: 99%

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Cross-Sectional and Longitudinal Risk of Physical Impairment in a Cohort of Postmenopausal Women Who Experience Physical and Verbal Abuse

2015

The Gerontologist

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Background: Exposure to interpersonal violence, namely verbal and physical abuse, is a highly prevalent threat to women's health and well-being. Among older, post-menopausal women, several researchers have characterized a possible bi-directional relationship of abuse exposure and diminished physical functioning. However, studies that prospectively examine the relationship between interpersonal abuse exposure and physical functioning across multiple years of observation are lacking. To address this literature gap, we prospectively evaluate the association between abuse exposure and physical functioning in a large, national cohort of post-menopausal women across 12 years of follow-up observation. Methods: Multivariable logistic regression was used to measure the adjusted association between experiencing abuse and physical function score at baseline in 154,902 Women's Health Initiative (WHI) participants. Multilevel modeling, where the trajectories of decline in physical function were modeled as a function of time-varying abuse exposure, was used to evaluate the contribution of abuse to trajectories of physical function scores over time. Result: Abuse was prevalent among WHI participants, with 11 % of our study population reporting baseline exposure. Verbal abuse was the most commonly reported abuse type (10 %), followed by combined physical and verbal abuse (1 %), followed by physical abuse in the absence of verbal abuse (0.2 %). Abuse exposure (all types) was associated with diminished physical functioning, with women exposed to combined physical and verbal abuse presenting baseline physical functioning scores consistent with non-abused women 20 years senior. Results did not reveal a differential rate of decline over time in physical functioning based on abuse exposure. Conclusions: Taken together, our findings suggest a need for increased awareness of the prevalence of abuse exposure among postmenopausal women; they also underscore the importance of clinician's vigilance in their efforts toward the prevention, early detection and effective intervention with abuse exposure, including verbal abuse exposure, in post-menopausal women. Given our findings related to abuse exposure and women's diminished physical functioning at WHI baseline, our work illuminates a need for further study, particularly the investigation of this association in younger, pre-menopausal women so that the temporal ordering if this relationship may be better understood.

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Section: Introductionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Cross-Sectional and Longitudinal Risk of Physical Impairment in a Cohort of Postmenopausal Women Who Experience Physical and Verbal Abuse

2015

The Gerontologist

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“…26 Other studies have mentioned the expression "frailty", although without any established conceptual and operational definition, and have correlated this with neglect of care and signs of abandonment among hospitalized elderly people; 27 or with specific components of vulnerability to abuse among elderly people, with regard to disability and mortality rates. 28 One point that needs to be mentioned In the spatial analysis, regardless of frailty status and its relationship with violence, the clusters of elderly were largest in the same region of the southeast of the municipality. This suggests that other factors, possibly relating to space, may have interfered with these variables.…”

Section: Discussionmentioning

confidence: 99%

Cross-sectional study on the association between frailty and violence against community-dwelling elderly people in Brazil

et al. 2018

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BACKGROUND: The physical, emotional and cognitive limitations that may be present in the aging process, coupled with family unpreparedness, may lead to greater dependence among the elderly. This favors development of frailty syndrome and greater levels of violence against the elderly. The objective here was to analyze the association between violence against the elderly and frailty; and the geographic distribution of violence against the elderly according to the presence of frailty syndrome. DESIGN AND SETTING: Cross-sectional study on 705 community-dwelling elderly people in Uberaba (MG), Brazil. METHODS: The Fried frailty phenotype and conflict tactics scale were used. Data were analyzed using descriptive statistics, the chi-square test and a logistic regression model. The intensity of the events and the relationship between clusters of violence and frailty status were assessed by means of kernel estimation. RESULTS: The adjusted analysis indicated that pre-frailty and frailty were associated with physical and verbal aggression (odds ratio, OR = 1.51; 95% confidence interval, CI: 1.04-2.19; OR = 2.12; 95% CI: 1.29-3.47), frailty was associated with physical aggression (OR = 2.48; 95% CI: 1.25-4.94) and pre-frailty and frailty were associated with verbal aggression (OR = 1.48; 95% CI: 1.03-2.15; OR = 2.15; 95% CI: 1.31-3.52), respectively. Regardless of frailty status and its relationship with violence, clusters of occurrences were larger in similar regions in the southeastern part of the municipality; but superimposition of overlays relating to aggression showed that for frail individuals the clusters were smaller than for non-frail and pre-frail individuals. CONCLUSIONS: The condition of frailty was associated with greater chances of violence against the elderly.

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“…3–7 In addition, many older adults self-neglect, 9,10 threatening their own health and safety by failing to perform or refusing assistance with essential self-care. Elder mistreatment victims have significantly increased mortality 8,11,12 and are at higher risk for adverse health outcomes including depression, 13 disability, 14 hospitalization, 15 and nursing home placement. 16,17 Unfortunately, fewer than 1 in 24 cases of elder mistreatment are identified and reported to the authorities.…”

Section: Introductionmentioning

confidence: 99%

Emergency Medical Services Perspectives on Identifying and Reporting Victims of Elder Abuse, Neglect, and Self-Neglect

Rosen

Lien

Stern

et al. 2017

The Journal of Emergency Medicine

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Background Emergency Medical Services (EMS) providers, who perform initial assessments of ill and injured patients, often in a patient’s home, are uniquely positioned to identify potential victims of elder abuse, neglect, or self-neglect. Despite this, few organized programs exist to ensure EMS concerns are communicated to or further investigated by other health care providers, social workers, or the authorities. Objective To explore attitudes and self-reported practices of EMS providers surrounding identification and reporting of elder mistreatment Methods Five semi-structured focus groups with 27 EMS providers Results Participants reported believing they frequently encountered and were able to identify potential elder mistreatment victims. Many reported infrequently discussing their concerns with other health care providers or social workers and not reporting them to the authorities due to barriers: (1) lack of EMS protocols or training specific to vulnerable elders, (2) challenges in communication with emergency department providers, including social workers, who are often unavailable or not receptive, (3) time limitations, and (4) lack of follow-up when EMS providers do report concerns. Many participants reported interest in adopting protocols to assist in elder protection. Additional strategies included photographically documenting the home environment, additional training, improved direct communication with social workers, a dedicated location on existing forms or new form to document concerns, a reporting hotline, a system to provide feedback to EMS, and community paramedicine. Conclusions EMS providers frequently identify potential victims of elder abuse, neglect, and self-neglect, but significant barriers to reporting exist. Strategies to empower EMS providers and improve reporting were identified.

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Mortality and Disability Outcomes of Self‐Reported Elder Abuse: A 12‐Year Prospective Investigation

Abstract: Specific components of vulnerability to elder abuse were differently associated with rates of disability and mortality over the ensuing 12 years.

Cited by 120 publications

References 32 publications

Cross-Sectional and Longitudinal Risk of Physical Impairment in a Cohort of Postmenopausal Women Who Experience Physical and Verbal Abuse

Cross-Sectional and Longitudinal Risk of Physical Impairment in a Cohort of Postmenopausal Women Who Experience Physical and Verbal Abuse

Cross-sectional study on the association between frailty and violence against community-dwelling elderly people in Brazil

Emergency Medical Services Perspectives on Identifying and Reporting Victims of Elder Abuse, Neglect, and Self-Neglect

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