The prevalence and correlates of elder abuse and neglect in a rural community of Negeri Sembilan state: baseline findings from The Malaysian Elder Mistreatment Project (MAESTRO), a population-based survey

Abstract

BackgroundAs Malaysia is fast becoming an ageing nation, the health, safety and welfare of elders are major societal concerns. Elder abuse is a phenomenon recognised abroad but less so locally. This paper presents the baseline findings from the Malaysian Elder Mistreatment Project (MAESTRO) study, the first community-based study on elder abuse in Malaysia.DesignCross-sectional study, analysing baseline findings of a cohort of older adults.SettingKuala Pilah district, Negeri Sembilan state, Malaysia.ObjectivesTo determine the prevalence of elder abuse among community dwelling older adults and its associated factors.ParticipantsA total of 2112 community dwelling older adults aged 60 years and above were recruited employing a multistage sampling using the national census.Primary and secondary outcome measuresElder abuse, measured using a validated instrument derived from previous literature and the modified Conflict Tactic Scales, similar to the Irish national prevalence survey on elder abuse with modification to local context. Factors associated with abuse and profiles of respondents were also examined.ResultsThe prevalence of overall abuse was reported to be 4.5% in the past 12 months. Psychological abuse was most common, followed by financial, physical, neglect and sexual abuse. Two or more occurrences of abusive acts were common, while clustering of various types of abuse was experienced by one-third of abused elders. Being male (adjusted OR (aOR) 2.15, 95% CI 1.23 to 3.78), being at risk of social isolation (aOR 1.96, 95% CI 1.07 to 3.58), a prior history of abuse (aOR 3.28, 95% CI 1.40 to 7.68) and depressive symptomatology (aOR 7.83, 95% CI 2.88 to 21.27) were independently associated with overall abuse.ConclusionElder abuse occurred among one in every 20 elders. The findings on elder abuse indicate the need to enhance elder protection in Malaysia, with both screening of and interventions for elder abuse.

The time has come to eliminate the gaps in the under-recognized burden of elder mistreatment: A community-based, cross-sectional study from rural eastern Nepal

“…The review published in Lancet in 2017 showed the pooled prevalence estimates for different subtypes of elder mistreatment: 11·6% (8·1–16·3) for psychological mistreatment, 6·8% (5·0–9·2) for financial mistreatment, 4·2% (2·1–8·1) for neglect, 2·6% (1·6–4·4) for physical mistreatment, and 0·9% (0·6–1·4) for sexual mistreatment [ 8 ]. A recently published Malaysian study reported a prevalence of 4.5% in the community setting [ 9 ]. A recent scoping review by Pillemer et al showed that elderly adults’ functional dependence, ethnicity, gender, age, poor physical health, low income, and substance abuse are strongly associated with elder mistreatment; however, the findings mentioned social support and living arrangements as protective factors against elder mistreatment [ 10 ].…”

“…Elder issues are not considered a major issue needing attention, given that the Nepalese cultural milieu is bound by strong family ties. However, there is a growing need to shift thinking towards issues faced by elders due to growing generation gaps, the mobility of economically active people for jobs and better education, adjustment problems, disrespect by the younger generation and abusive behavior from family members and caregivers, all of which have affected the lives of elders [ 9 , 10 , 13 ]. In a survey of 212 elderly people in urban Nepal, the rate of some form of elder mistreatment was found to be 49.1% [ 13 ].…”

The Prevalence of Various Abuse Types and Their Associated Factors in the Elderly

“…Such problems may lead to long-term care and its related costs that might lead to elder abuse [5]. Elder abuse is a common problem which has not been recognized in developing countries [6]. Elder abuse is a significant public health issue.…”

Does abuse in late life worsen sleep quality? A two‐year prospective cohort study among rural older adults

“…A 12month prevalence of EAN in rural Malaysia was estimated at 4.5%. 22 Assessment of PSQI score at baseline and T2 revealed a downward trend, which is contrary to the common notion that sleep quality declines with age. First, a period of 2 years may have not been adequate for significant changes (decline) or trend in changes in sleep quality to manifest.…”

“…For instance, some studies define EAN as occurrences within the past 12 months, while some others—including this study—take into account all abuse episodes from the age of 60. A 12‐month prevalence of EAN in rural Malaysia was estimated at 4.5% …”