Elder Abuse as a Risk Factor for Hospitalization in Older Persons Elder Abuse as a Risk Factor for Hospitalization

Dong X, Simon MA. — Mon, 08 Apr 2013 00:00:00 GMT

Importance

Elder abuse is associated with increased mortality risk. However, the relationship between elder abuse and health care services utilization remains unclear.

Objective

To examine the relationship between overall elder abuse and specific subtypes of elder abuse and rate of hospitalization in a community-dwelling population of older adults.

Design

Prospective population-based study.

Setting

Chicago Health and Aging Project.

Participants

Of the 6674 community-dwelling older adults who participated in the Chicago Health and Aging Project, 106 were identified by social services agencies for elder abuse.

Main Outcomes and Measures

The primary predictor was elder abuse (reported and confirmed) reported to social services agency. The outcome of interest was the annual rate of hospitalization obtained from the Centers for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships.

Results

The unadjusted mean annual rate of hospitalization was 0.62 (95% CI, 0.59-0.66) for those without elder abuse and 1.97 (95% CI, 1.33-2.61) for those with reported elder abuse. After adjusting for sociodemographic and socioeconomic variables, medical comorbidities, cognitive and physical function, and psychosocial well-being, reported elder abuse had higher rates of hospitalization (rate ratio [RR], 2.00 [95% CI, 1.45-2.75]). 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]), and 2 or more types of elder abuse (RR, 2.59 [95% CI, 1.82-3.66]) were associated with increased rates of hospitalization, after considering the same potential confounders. Results from interaction term analyses suggested that the association between elder abuse and hospitalization did not differ across the levels of medical comorbidities, cognitive and functional impairment, or psychosocial distress.

Conclusions and Relevance

Elder abuse was associated with increased rates of hospitalization in this community population. Future research is needed to explore the causal mechanisms between elder abuse and hospitalization. As we enter the era of health care reform, an improved understanding of factors that increase rates of hospitalization could also have significant implications for social and health policy as well as clinical care of the vulnerable patients.

Promoting Good Clinical Care to Prevent Elder Abuse Comment on “Elder Abuse as a Risk Factor for Hospitalization in Older Persons” Promoting Clinical Care to Prevent Elder Abuse

Monod S. — Mon, 08 Apr 2013 00:00:00 GMT

Elder abuse has received increasing attention over the last 2 decades, and its prevalence will likely increase as the aged population increases. Elder abuse is commonly defined as “a single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person.” Different types of elder abuse have been defined: (1) physical abuse (infliction of pain or injury); (2) psychological abuse (infliction of mental anguish); (3) sexual assault (nonconsensual contact of any kind); (4) financial exploitation (illegal or improper use of funds or resources), and (5) neglect (failure of a caregiver to meet the needs of a dependant person). Elder abuse may occur in the community, as well as in institutions like nursing homes or hospitals.

JAMA Internal Medicine: Elder Abuse Topic Collection

Elder Abuse as a Risk Factor for Hospitalization in Older Persons Elder Abuse as a Risk Factor for Hospitalization

Promoting Good Clinical Care to Prevent Elder Abuse Comment on “Elder Abuse as a Risk Factor for Hospitalization in Older Persons” Promoting Clinical Care to Prevent Elder Abuse