Table 3.
Consequences of Elder Abuse (EA)
| Author, Year | Type | Study Description | Age; Sex; Race | Predictor | Outcomes | Confounding Factors | Critical Findings |
|---|---|---|---|---|---|---|---|
| Schofield, 201396 | PS | 1,266 older women In Australia | 70–75; 100% female | EA | Disability mortality | Demographic factors, social support, health behaviors, health condition | Mortality: coercion (HR = 1.21, 95% CI = 1.06–1.40), dejection (HR = 1.12, 95% CI = 1.03–1.23) Disability: vulnerability (HR = 1.25, 95% CI = 1.06–1.49), dejection (HR = 1.55, 95% CI = 1.38–1.73) |
| Dong, 201260 | PS | 6,864 community-living older adults participating In CHAP | ≥65; 61% female | SN | Emergency department use | Soclodemographlc, medical conditions, cognitive and physical function | SN (RR = 1.42, 95% CI = 1.29–1.58), greater SN severity (mild: PE = 0.27, SE = 0.04, P< .001; moderate: PE = 0.41, SE = 0.03, P < .001; severe: PE = 0.55, SE = 0.09, P< .001) |
| Dong, 201097 | PS | 7,841 community-older adults participating In CHAP | ≥65, 52.6% female | EA | All-cause mortality across levels of depression, social network, social participation | Soclodemographlc, medical conditions, weight loss, marital status, cognitive and physical function, smoking, alcohol Intake | CES-D fertile: highest (HR = 2.17, 95% CI = 1.36–4.36), middle (HR = 2.18, 95% CI = 1.19–3.99), lowest (HR = 1.61, 95% CI = 0.79–3.27) Social network fertile: lowest: (HR = 2.42, 95% CI = 1.52–3.85), middle (HR = 2.65, 95% CI = 1.52–4.60), highest (HR = 0.97, 95% CI = 0.36–2.61) Social engagement fertile: lowest: (HR = 2.32, 95% CI = 1.47–3.68), middle (HR = 2.59, 95% CI = 1.41–4.77), highest (HR = 1.19, 95% CI = 0.52–2.72) |
| Mouton, 201051 | PS | 93,676 from the Women’s Health Initiative (WHI) Observational Study | 50–79; 100% female | Physical, verbal abuse | Depressive symptoms, MCS score | Soclodemographlc, marital status, smoking, alcohol, religion comfort, living alone, baseline psychosocial characteristics | Physical abuse: 3-year change In depressive symptoms (PE = 0.20, 95% CI = −0.21–0.60), change In MCS score (PE = −1.12, 95% CI = −2.45 to −0.21) Verbal abuse: 3-year change In depressive symptoms (PE = 0.18, 95% CI = 0.11–0.24), change In MCS score (PE = 0.55, 95% CI = −0.75 to −0.34) Physical and verbal abuse: 3-year change In depressive symptoms (PE = 0.15, 95% CI = −0.05 to 0.36), change In MCS score (PE = −0.44, 95% CI = −1.11 to −0.22) |
| Baker, 200953 | PS | 160,676 community women from WHI | 50–79; 100% female | Physical, verbal abuse | All-cause, cause-specific mortality | Sociodemographic, BMI, smoking, alcohol, health status, medical conditions, frailty, and psychosocial factors | Physical abuse (HR = 1.40, 95% CI = 0.93–2.11), verbal abuse (HR = 1.02, 95% CI = 0.94–1.10), physical and verbal abuse (HR = 1.07, 95% CI = 0.86–1.33) |
| Dong, 20095 | PS | 9,318 community-older adults participating in CHAP | ≥65; 61% female | EA, SN | All-cause mortality, cause-specific mortality, mortality stratified according to cognitive and physical function | Sociodemographic, medical conditions, weight loss, marital status, cognitive and physical function, BMI, CES-D, cigarette smoking, alcohol use, social well-being | SN: 1-year mortality (HR = 5.76, 95% CI = 5.11–6.49), >1-year mortality (HR = 1.87, 95% CI = 1.64–2.14) SN severity: mild (HR = 4.71, 95% CI = 3.59–6.17), moderate (HR = 5.87, 95% CI = 5.12–6.73), severe HR = 15.47, 95% CI = 11.18–21.41). EA: all-cause mortality (HR = 2.06, 95% CI = 1.48–2.88), cardiovascular mortality (HR = 3.86, 95% CI = 2.04–7.29) |
| Schofield,200455 | PS | 10,421 older women in Australia | 73–78; 100% female | EA | Physical function, bodily pain, general health, social function, role emotional difference, mental health difference, PCS T2–1, MCS T2–1 difference | Baseline Medical Outcomes Study 36-item Short Form Survey scores, four EA scores, age, sum of acute illnesses, chronic conditions, life events, stress score, violent relationship, BMI, smoking, marital status, education, country of birth | Dejection predicted physical function (β = −2.81, SE = 0.81), bodily pain (β = −1.99, SE = 0.97), general health (β = −1.61, SE = 0.70), vitality (β = −3.54, SE = 0.71), social function (β = –5.27, SE = 1.00), role emotional difference (β = −7.88, SE = 1.60), mental health difference (β = −4.63, SE = 0.60), PCS T2–1 difference (β = −0.75, SE = 0.36), MCS T2–1 difference (β = −0.41, SE = 0.74), |
| Lachs, 200257 | PS | 2,812 community-living older adults from New Haven EPESE cohort | ≥65; 58.4% female | EA, SN | Long-term nursing home placement | Sociodemographic, BMI, medications, physical and cognitive function, social ties, incontinence, CES-D, emotional support, chronic conditions | SN (HR = 5.23, 95% CI = 4.07–6.72), EA (HR = 4.02, 95% CI = 2.50–6.47) |
| Lachs, 199818 | PS | 2,812 community-living older adults from New Haven EPESE | ≥65; 58.4% female | EA, SN | All-cause mortality | Sociodemographic, chronic conditions, BMI, cognition, psychosocial well-being | SN (OR = 1.70, 95% CI = 1.20–2.50), EA (OR = 3.10, 95% CI = 1.40–6.70) |
| Dong, 201361 | CS | 6,674 community-living older adults participating in CHAP | ≥65; 58.4% female; 56.3% black | EA; psychological, financial abuse; neglect | Hospitalization | Sociodemographic, medical comorbidities, cognitive and physical function, psychological well-being | Elder abuse (RR = 2.72, 95% CI = 1.84–4.03), psychological abuse (RR = 2.22, 95% CI = 1.44–3.43), financial exploitation (RR = 1.75, 95% CI = 1.06–2.90), caregiver neglect (RR = 2.43, 95% CI = 1.60–3.69), ≥2 types of elder abuse (RR = 2.59, 95% CI = 1.82–3.66) |
| Dong, 201361 | CS | 10,333 community-older adults participating in CHAP | ≥65; 39% female | SN | EA | Sociodemographic, medical comorbidities, cognitive and physical function, psychosocial | EA (OR = 1.75, 95% CI = 1.19–2.59), financial exploitation (OR = 1.73, 95% CI = 1.01–2.95), caregiver neglect (OR = 2.09, 95% CI = 1.24–3.52), multiple forms of EA (OR = 2.06, 95% CI = 1.22–3.48) |
| Dong, 201361 | CS | 6,674 community-older adults participating in CHAP | ≥65; 58.4% female | EA | Rate of emergency department use | Sociodemographic, comorbidities, cognitive and physical function, psychosocial | EA (RR = 2.33, 95% CI = 1.60–3.38), psychological abuse (RR=1.98, 95% CI = 1.29–3.00), financial exploitation (RR = 1.59, 95% CI = 1.01–2.52), caregiver neglect (RR = 2.04, 95% CI = 1.38–2.99) |
| Dong, 201361 | CS | 6,674 community-older adults participating in CHAP | ≥65; 58.4% female | EA | Rates of admission to skilled nursing facilities | Sociodemographic, medical comorbidities, cognitive and physical function, psychosocial | EA (RR = 4.60, 95% CI = 2.85–7.42), psychological (RR = 2.31, 95% CI = 1.17–4.56), physical (RR = 2.36, 95% CI = 1.19–4.66), financial (RR = 2.81, 95% CI = 1.53–5.17), neglect (RR = 4.73, 95% CI = 3.03–7.40) |
| Olofsson, 201252 | CS | 9,360 older adults from nationwide public health survey in Sweden | 65–84; 53.1% female | Psychological and physical abuse | Physical and mental health, use of healthcare | Age, civil status, work history, smoking | Psychological abuse (women): poor general health (OR = 3.80, 95% CI = 2.70–5.30), anxiety (OR = 6.30, 95% CI = 3.70–11.00), stress (OR = 6.30, 95% CI = 4.20–9.30), GHQ-12 (OR = 5.90, 95% CI = 4.40–7.90), suicidal thought (OR = 3.50, 95% CI = 2.30–5.20), use of healthcare (OR = 2.60, 95% CI = 1.90–3.50) Physical abuse (women): anxiety (OR = 7.40, 95% CI = 3.60–15.0), sleeping problem (OR = 2.30, 95% CI = 1.40–4.50), stress (OR = 3.80, 95% CI = 1.90–7.60), GHQ-12 (OR = 4.00, 95% CI = 2.40–6.70), pharmaceutical (OR = 2.10, 95% CI = 1.20–3.40), use of healthcare (OR = 1.80, 95% CI = 1.00–3.10). Psychological abuse (men): poor general health (OR = 2.20, 95% CI = 1.40–3.40), anxiety (OR = 10.00, 95% CI = 5.30–19.00), sleeping problem (OR = 3.50, 95% CI = 2.10–5.90), stress (OR = 5.70, 95% CI = 3.50–9.50), GHQ-12 (OR = 3.90, 95% CI = 2.70–5.70), suicidal thought (OR = 7.30, 95% CI = 4.60–11.00), suicide attempt (OR = 5.30, 95% CI = 2.30–12.00) Physical abuse (men): poor general health (OR = 2.20, 95% CI = 1.20–4.10), anxiety (OR = 7.1, 95% CI = 3.0–16.0), stress (OR = 5.90, 95% CI = 3.10–11.00), GHQ-12 (OR = 3.20, 95% CI = 1.90–5.50), suicidal thought (OR = 4.70, 95% CI = 2.40–9.00), suicide attempt (OR = 5.40, 95% CI = 1.80–16.00) |
| Begle, 201150 | CS | 902 adults aged ≥60 using stratified random digit dialing, computer-assisted telephone interview | ≥60; 59.9% female | Emotional, sexual, physical abuse | Negative emotional symptoms (anxious, depressed, irritable) | Sociodemographic, health status, social support, social services, physical function | Emotional abuse (OR = 2.13, 95% CI = 1.04–4.36), physical abuse (OR = 0.67, 95% CI = 0.22–2.03) |
| Cisler, 201098 | CS | 902 adults aged ≥60 in South Carolina | ≥60; 60% female | EA | Self-rated physical health | Income, needing help with ADLs, emotional symptoms | Prior exposure to potentially traumatic events (OR = 1.89, 95% CI = 1.18–3.03) |
| Fisher, 200699 | CS | 842 community-living women who completed telephone survey | ≥60; 100% female | EA | Health status, medical conditions, psychological distress, digestive problems | Age, sex, race, education, marital status, income, Appalachian heritage | Greater depression or anxiety (OR = 2.24, 95% CI = 1.70–2.96), greater digestive problems (OR = 1.60, 95% CI = 1.22–2.09), greater chronic pain (OR = 1.65, 95% CI = 1.28–2.15) |
| Smith, 2006100 | CS | 80 APS referrals along with matched control subjects from clinical population | Mean 76; 62.5% female | SN | Complete blood count and chemistry, oxidative damage and antioxidants, fat-soluble vitamins, vitamin B-12 and folate, calcium and bone metabolism | N/A | Serum concentration of total homocysteine 13.6 ± 4.5, μmol/L, P < .05; red blood cell folate concentration 1,380 ± 514 nmol/L, P < .05; plasma b-carotene 0.28 ± 0.2 μmol/L, P < .05; X-tocopherol 23.2 ± 9.3 μmol/L, P < .05; 25-hydroxyvitamin-D serum concentration 33.7 ± 16.4 nmol/L, P < .05 |
| Franzini, 2008101 | CC | 131 APS clients and 131 matched controls to an interdisciplinary geriatric medicine clinic | ≥65; 69.5% female | SN | Health utilization, clinic visits, house calls, hospital stays, length of stay healthcare costs | Age, sex, race, mental disorders | Total cost: $12,466 for SN vs $19,510 for control (P = .36) Physician costs, PE −0.29 (0.40); outpatient payments, PE −0.24 (0.45); inpatient costs, PE −0.20 (0.28); total Medicare costs, PE —0.36 (0.33); clinic visits, PE −0.24 (0.10); hospital stays, PE −0.51 (0.05) |
| Mouton, 1999102 | CS | 257 women aged 50 | 50–79; 100% female | Psych Abuse | Mental health | Age, race, marital status, family income, and education | Being threatened (PE −3.32, P = .01) |
Parameter estimate (PE) is a coefficient of change in the outcome for every unit increase in the predictor variable of interest.
PS = prospective; HR = hazard ratio; CI = confidence interval; CHAP = Chicago Health Aging Project; SN = self-neglect; CES-D = Center for Epidemiologic Study Depression Scale; RR = risk ratio; SE = standard error; WHI = Women’s Health Initiative; BMI = body mass index; MCS = Mental Component Summary; EPESE = Established Populations for Epidemiologic Studies of the Elderly; GHQ-12 = General Health Questionnaire; APS = Adult Protective Services.