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Peter A S, Prabhu MM, Tolson D, Nayak BS, Bhandary RP, V B, Devi ES. Effectiveness of interventions to prevent abuse in people living with dementia in community settings: A systematic review. DEMENTIA 2024:14713012241260476. [PMID: 38901056 DOI: 10.1177/14713012241260476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
OBJECTIVES This review examined the evidence for interventions to prevent the abuse of people living with dementia in the community. METHODS The articles were retrieved from 2000 to 2023 from six databases, including MEDLINE via PubMed, CINAHL Plus via EBSCO, EMBASE, ProQuest Medical Library, Web of Science, and Scopus. The research articles that focused on finding the effectiveness of interventions for preventing abuse of people living with dementia in community settings were included in this review. The review included randomized controlled trials and pre-test post-test trials only. The quality appraisal of the eligible studies was done using ROB 2 and ROBINS II. The findings were tabulated and narratively synthesised. RESULTS Out of 1831 articles, only three were included in this review. Only two RCTs were included in this efficacy review. Both the studies showed that the interventions were not effective in reducing abuse. The studies utilised family caregiver interventions like psychological interventions and online supportive education. The review identified psychological interventions with some evidence. Another study was a quasi-experimental study that used dialectical behaviour therapy as an intervention to reduce abuse occurrence. The study showed low evidence and focused only on reporting of elder abuse as an outcome. CONCLUSION This review found very few studies and was not able to draw a conclusion on the effectiveness of interventions for abuse in people living with dementia. Given the paucity of research, there is a clear need to identify how to overcome the challenges faced in elder abuse research and further refine the development of approaches to reduce elder abuse among people living with dementia in community settings.
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Affiliation(s)
- Seelia Peter A
- Department of Medical Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka,India 576104
| | - M Mukhyaprana Prabhu
- Department of General Medicine, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India 576104
| | - Debbie Tolson
- Alzheimer's Scotland Centre for Policy and Practice, University of West of Scotland, UK; School of Health and Life Sciences, University of West of Scotland, UK
| | - Baby S Nayak
- Department of Child Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India 576104
| | - Rajeshkrishna P Bhandary
- Department of Psychiatry, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India 576104
| | - Binil V
- Department of Psychiatric (Mental Health) Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India 576104
| | - Elsa Sanatombi Devi
- Department of Medical Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India 576104
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Yang Y, Huang J, Wang M, Wang F, Luo H, Fan B, Huang Y, Xu W, Zheng C, Zhang M. The domestic elder abuse in China: Scale development and psychometric properties. Geriatr Nurs 2024; 56:7-13. [PMID: 38185005 DOI: 10.1016/j.gerinurse.2023.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 01/09/2024]
Abstract
An effective screening tool is essential to elder abuse research. Although several instruments have been developed in China to measure elder abuse, they present several limitations. The instrument development involved three components: (1) generating questionnaire items; (2) questionnaire testing and data collection in older adults; and (3) psychometric evaluation of the Domestic Elder Abuse Scale (DEAS). We collected questionnaire responses from 3725 community-dwelling Chinese older adults. The 26-item DEAS showed good reliability and validity across five dimensions: physical abuse, psychological abuse, financial exploitation, neglect, and abandonment. These five factors accounted for 78.432 % of the total variance, and model fitting results were acceptable. The Cronbach's alpha coefficient of the scale was 0.975, and the test-retest intraclass correlation coefficient (ICC) was 0.934 after 2 weeks. This study developed a five-dimension instrument to measure elder abuse, with good psychometric properties, which can play an essential role in community-based studies in China.
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Affiliation(s)
- Yeqin Yang
- School of Nursing, Wenzhou Medical University, University Town, Chashan, Wenzhou, Zhejiang, China; School of Nursing, Zhejiang Chinese Medical University, Binjiang District, Hangzhou, Zhejiang, China.
| | - Jin Huang
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Lucheng District, Wenzhou, Zhejiang, China
| | - Meng Wang
- School of Nursing, Wenzhou Medical University, University Town, Chashan, Wenzhou, Zhejiang, China
| | - Fang Wang
- School of Nursing, Wenzhou Medical University, University Town, Chashan, Wenzhou, Zhejiang, China
| | - Huiyun Luo
- School of Nursing, Wenzhou Medical University, University Town, Chashan, Wenzhou, Zhejiang, China
| | - Bingjie Fan
- School of Nursing, Wenzhou Medical University, University Town, Chashan, Wenzhou, Zhejiang, China
| | - Yiru Huang
- School of Nursing, Wenzhou Medical University, University Town, Chashan, Wenzhou, Zhejiang, China
| | - Wenxian Xu
- The First Affiliated Hospital of Wenzhou Medical University, Ouhai District, Wenzhou, Zhejiang, China
| | - Chonghao Zheng
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Lucheng District, Wenzhou, Zhejiang, China
| | - Mengqi Zhang
- School of Nursing, Wenzhou Medical University, University Town, Chashan, Wenzhou, Zhejiang, China
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Fang B, Li D, Yan E, Zhou Y, Yu Z, Hu J. Associated factors of discrepancy between older adults and their family caregivers in reporting elder abuse. J Clin Nurs 2023; 32:688-700. [PMID: 35289011 DOI: 10.1111/jocn.16283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 12/28/2021] [Accepted: 02/04/2022] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES This study focuses on elder abuse against older adults with mild-to-moderate cognitive and physical impairment who were receiving family care in Chinese context. Specifically, the study examined the associated factors of discrepancy between family caregiver and care recipient reports of elder abuse committed by the caregivers. BACKGROUND Many studies identified the discrepancies between caregivers and care recipients reports of elder abuse, but they did not examine factors contributing to such discrepancies. Various cultural factors may contribute to the accuracy of elder abuse reports. METHODS A consecutive sample of 1,002 older adults with mild-to-moderate cognitive and physical impairment and their family caregivers was surveyed. DESIGN Quantitative study with cross-sectional design. RESULTS Moderate-to-substantial agreement in caregiver and care recipient reports was found for all forms of abuse (Cohen's kappa = 0.39 to 0.76). Care recipient reports consistently generated higher rates than caregiver reports for psychological abuse (51.1% vs. 42.8%), physical abuse (1.2% vs. 1.0%), caregiver neglect (65.0% vs. 50.2%) and financial exploitation (40.8% vs. 34.2%). Similar factors were found for dyadic discrepancy in the reporting of various forms of elder abuse, which included desire to gain face, fear of losing face and sense of familism in the caregivers, as well as older age, cognitive impairment and female gender of the care recipient. This study was presented in adherence to the Strobe Checklist. CONCLUSIONS The results suggest that family caregivers might not be reliable as the sole informants to report their care recipients' victimization experiences. Information from multiple parties should be gathered and synthesized to obtain more accurate reporting of the frequency and severity of elder abuse. Meanwhile, cultural factors should be taken into account when seeking information related to elder abuse. RELEVANCE TO CLINICAL PRACTICE There is a need for multiple parties to provide and report information about the elder abuse. It is also need to consider cultural factors when detecting and intervening elder abuse.
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Affiliation(s)
- Boye Fang
- School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, China
| | - Danyu Li
- School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, China
| | - Elsie Yan
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong
| | - Yi Zhou
- School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, China
| | - Zhuopeng Yu
- School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, China
| | - Jian Hu
- Department of Hematology, Xiangya Hospital, Central South University, Changsha, China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Intersections between the culture of Xiao (孝) and caring for older relatives in China: perspectives of United Kingdom-based Chinese students on future care for their parents. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x22001118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Emphasis placed on Xiao (孝; filial piety) in Chinese culture highlights parents' investment in their children with the expectation of being cared for when older. An increasing number of Chinese students come to the United Kingdom (UK) to study, with the majority returning home and likely to become future care-givers for their parents. Little attention has been paid to the implications of transnational mobility of Chinese students on the reciprocal aspects of future care responsibility. With the uniquely changing family structure due to consequences of the One-Child Policy, we conducted proactive research on the opportunities and challenges that Chinese transnational students anticipate they may face in future care-giving for elderly parents. Hence, this study's aim was to make a novel contribution to knowledge through exploration of the perspectives of Chinese students in England on intergenerational ties and filial obligations. Adopting a social constructivist philosophical position, we conducted three focus groups with 19 UK-based Chinese students, using a semi-structured topic guide with informed consent. Interviews were translated, transcribed and analysed using reflective thematic analysis, capturing semantic and latent meanings, and employed a descriptive and interpretative approach. Six themes were discovered, revealing a ‘culture of duty’ where familial obligation and societal expectations were prominent. Prospective care-givers anticipated a future dilemma between balancing work commitments and providing care as mandated by Xiao. Furthermore, it appeared that lack of preparedness might further exacerbate barriers faced when accessing support. We surmised that the changing demographics and absence of formal support could compound stressors over time, especially if cognitive dissonance arises as realities of life do not fit with societal expectations. Our findings imply that policy makers, practitioners and the government will need to adequately support prospective family care-givers who are returnees in caring for older generations.
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Chen M, Fu Y. Adverse Childhood Experiences: Are They Associated With Greater Risk of Elder Abuse Victimization? JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP17662-NP17687. [PMID: 34641720 DOI: 10.1177/08862605211028328] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Though a growing number of studies have examined the associations between adverse childhood experiences (ACEs) and negative later-life health outcomes, the effects of these early life-course factors on elder abuse victimization have yet to be fully investigated. Using a life-course perspective, this study examines the associations between ACEs and elder abuse victimization. We used data from a cross-sectional survey conducted in Beijing, China. A total of 1,002 older adults were included in this study. Retrospective self-report items were used to measure ACEs and elder abuse victimization in later life. Univariate and multivariate logistic regressions were performed to examine the associations between ACEs and elder abuse victimization. Five types of ACEs (i.e., socio-economic difficulty of the original family, parental divorce, frequent quarrels between parents, frequent physical punishment by parents, and starvation) were associated with a higher risk of elder abuse victimization. After controlling for participants' socio-demographic characteristics and adding these five types of ACEs simultaneously in the multivariate regression model, the poor socio-economic status of the original family (OR = 1.759, p < .05) and suffering frequent physical punishment inflicted by parents (OR = 2.288, p < .05) were found to be significantly associated with elder abuse victimization. To have multiple (at least 4) ACEs is a risk factor for elder abuse victimization as well (OR = 3.06, p < .001). This study provides evidence for ACEs as risk factors for elder abuse victimization. The findings highlight the importance of strengthening our understanding of the impacts of ACEs in both research and practice.
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Affiliation(s)
- Mengtong Chen
- The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China
| | - Yuanyuan Fu
- Beijing Normal University, Haidian, Beijing, China
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6
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Tian Z, Xiong C, Wang Y, Tao H, Zhou S, Yan J. Association between familism and mental health in dementia caregivers: a systematic review and meta-analysis. Psychogeriatrics 2022; 22:469-477. [PMID: 35636744 DOI: 10.1111/psyg.12843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 03/20/2022] [Accepted: 04/12/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Dementia caregivers suffer from mental health problems while caring for dementia patients. As a core value, familism has been linked to the mental health of dementia caregivers. This study aims to systematically review the familism of dementia caregivers and to examine the association between familism and mental health of anxiety, depression, and burden in empirical research studies. METHODS We conducted a systematic search in various databases like Medline, PubMed, and Embase databases from inception till April 2021. Fisher's z was calculated with correlation coefficient or regression coefficient values for three familism dimensions and mental health of anxiety, depression, and burden. All statistical analyses were performed using Comprehensive Meta-Analysis (CMA) version 2.0 software. RESULTS A total of seven studies with 1178 participants were eligible for the meta-analysis. For caregivers' anxiety, three of seven studies, with 358 participants, were examined in terms of the average corrected correlation coefficient across the studies. It was found that dementia caregivers' familism was significantly related to anxiety. The pooled z-value was 0.148 (95% CI = 0.043-0.253). In addition, caregivers' familism significantly affected depression (z = 0.080; 95% CI = 0.003-0.156), as did familial obligation (z = 0.122; 95% CI = 0.034-0.211), but perceived family support was not associated with this (z = 0.051, 95% CI = -0.038-0.140). As for caregiver burden, there was no evidence that familism was significantly associated with it (z = -0.073; 95% CI = -0.297 to 0.151), including familial obligation and perceived family support (z = -0.087 and -0.089, respectively; 95% CI = -0.278 to 0.104 and -0.335 to 0.157, respectively). CONCLUSIONS An association between caregiver familism and anxiety/depression exists in dementia patients. More research is needed to explore the relationship between familism and burden.
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Affiliation(s)
- Zhiwu Tian
- Blood Purification Centre, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Chuyan Xiong
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yingmin Wang
- Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hongmei Tao
- Blood Purification Centre, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Shuang Zhou
- Department of Nephrology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Jun Yan
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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Chao YY, Kong D, Seo JY, Zha P, Dong X. Perceived social support and help-seeking among U.S. Chinese older adults who reported elder mistreatment. J Elder Abuse Negl 2022; 34:222-240. [PMID: 35703546 DOI: 10.1080/08946566.2022.2089938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study aimed to examine the associations between perceived social support and help-seeking among U.S. Chinese older adults who reported elder mistreatment (EM). Data were from the Population Study of Chinese Elderly in Chicago. Perceived social support and informal/formal help-seeking intentions and behaviors were measured. Descriptive statistics, multiple linear regressions, and multinomial logistic regression analyses were performed. A total of 450 participants reported EM. Mean age of the sample was 72.73 ± 8.03 years old. Perceived social support was associated with an increase in intentions of seeking help from informal sources. Compared with not seeking help, older Chinese-American adults with any EM who perceived social support were more likely to seek help from informal and formal sources. The potential role of social support in increasing help-seeking was highlighted. Culturally tailored interventions that provide social support might promote help-seeking among U.S. Chinese elder immigrants who experienced EM.
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Affiliation(s)
- Ying-Yu Chao
- School of Nursing, Rutgers, The State University of New Jersey, Newark, New Jersey, USA
| | - Dexia Kong
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong
| | - Jin Young Seo
- School of Nursing, Hunter CollegeHunter-Bellevue, New York, New York, USA
| | - Peijia Zha
- School of Nursing, Rutgers, The State University of New Jersey, Newark, New Jersey, USA
| | - XinQi Dong
- Health Care Policy and Aging Research, Rutgers Institute for Health, New Brunswick, New Jersey, USA
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Chen M, Chan KL. Elder Abuse and Neglect in China: Prevalence, Co-occurrence, and Intergenerational Risk Factors. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP9839-NP9862. [PMID: 33415994 DOI: 10.1177/0886260520985501] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The prevalence and patterns of elder abuse and neglect in China have been understudied. The objectives of this study were to examine the chronicity and prevalence of different patterns of elder abuse, and the influence of individual and contextual risk factors. We used data from a sample of 7,466 adults randomly recruited from six regions in China. The participants responded to a questionnaire about their demographic characteristics, childhood abuse experiences, and instances of abuse and neglect against their elderly parents. Logistic regression analysis was performed to examine the association of elder abuse and neglect with individual and contextual factors. The results showed that one in 10 participants reported that their elderly parents had experienced abuse or neglect in the past year. The elder victims were reported to have suffered different types of abuse and neglect on multiple occasions, ranging from 3.6 to 11.82 times on average. More than 5% of participants reported that their elderly parents had suffered two or more types of abuse and neglect in the past year, accounting for 40% of the elderly victims. The co-occurrence of elder abuse within elderly couples was also high. Reports of abuse and neglect of elderly parents were related to low socioeconomic status, living in rural areas, and the experience of childhood abuse of the participants. This study supports the model of intergenerational transmission of violence in the Chinese population. The high prevalence, chronicity, and co-occurrence of elder abuse and neglect underline the importance of screening for risk factors, and have implications for preventive practice and policy.
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Fang B, Liu H, Yan E. Association Between Caregiver Depression and Elder Mistreatment-Examining the Moderating Effect of Care Recipient Neuropsychiatric Symptoms and Caregiver-Perceived Burden. J Gerontol B Psychol Sci Soc Sci 2021; 76:2098-2111. [PMID: 33598710 DOI: 10.1093/geronb/gbab025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES To examine the association between caregiver (CG) depression and increase in elder mistreatment and to investigate whether change in care recipient (CR) neuropsychiatric symptoms (NPS) and change in CG-perceived burden influence this association. METHODS Using 2-year longitudinal data, we analyzed a consecutive sample of 800 Chinese primary family CGs and their CRs with mild cognitive impairment or mild-to-moderate dementia recruited from the geriatric and neurological departments of 3 Grade-A hospitals in the People's Republic of China. Participatory dyads were assessed between September 2015 and February 2016 and followed for 2 years. RESULTS CG depression at baseline was associated with a sharper increase in psychological abuse and neglect. For CRs with increased NPS, having a depressed CG predicted a higher level of psychological abuse than for those CRs without NPS. For CGs with decreased burden, the level of depression was associated with a slower increase in neglect than for CGs who remained low burden. DISCUSSION This study showed the differential impact of CG depression on the increase in elder mistreatment depending on the change in CR NPS and CG-perceived burden. The present findings provide valuable insights into the design of a systematic and integrative intervention protocol for elder mistreatment that simultaneously focuses on treating CG depression and perceived burden and CR NPS.
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Affiliation(s)
- Boye Fang
- School of Sociology & Anthropology, Sun Yat-sen University, Guangdong Province, China
| | - Huiying Liu
- Department of Sociology, Central South University, Changsha, Hunan Province, China
| | - Elsie Yan
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong, China
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Chen Y, Guo M, Xu H, Liu Z, Barry LC, Wu C. Association between early life circumstances and depressive symptoms among Chinese older adults: Results from China health and retirement longitudinal study: Early life circumstances and depression. J Affect Disord 2021; 292:345-351. [PMID: 34139407 DOI: 10.1016/j.jad.2021.05.067] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/26/2021] [Accepted: 05/30/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND A growing body of literature suggests that early life circumstances can influence mental health throughout the lifespan. However, how these early life circumstances cumulatively contribute to depression in old age is not completely understood. The aim of this study was to examine the associations of eight factors with depression among community-dwelling older adults. METHODS Data were from the China Health and Retirement Longitudinal Study. We included 8,239 community-dwelling individuals who were ≥60 years, completed the life history questionnaire, and had assessment of depression. An early life disadvantage index was established using risk factors that were significantly associated with depression. Logistic regression was used to examine the association of each early life risk factor and the index with depression. RESULTS Of 8239 individuals included, 2,055 (24.9%) had depression. In bivariate analysis, each of eight early life risk factors was significantly associated with depression. Except for maternal and paternal education, all risk factors persisted to be associated with depression after multivariable adjustment. In the multivariable-adjusted model, a one-point higher in the early life disadvantage index (range: 0-6) was associated with a 45% (95% CI: 37%, 53%) higher odds of depression. LIMITATIONS Depressive symptoms were measured in our study only by the CES-D scale. Some early life experiences might not be fully reliable due to recall bias. CONCLUSION There was a strong association between early life environments and depressive symptoms among Chinese community-dwelling older adults. Adverse early life circumstances could contribute cumulatively to depression in old age.
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Affiliation(s)
- Yan Chen
- Global Health Research Center, Duke Kunshan University, Jiangsu, China; Global Health Institute, Wuhan University, Hubei, China
| | - Man Guo
- School of Social Work, University of Iowa, IA, USA
| | - Hanzhang Xu
- Department of Family Medicine and Community Health and School of Nursing, Duke University, NC, USA
| | - Zuyun Liu
- Department of Precision Health and Data Science, School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | | | - Chenkai Wu
- Global Health Research Center, Duke Kunshan University, Jiangsu, China.
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Fang B, Yan E, Yang X, Pei Y. Association between Caregiver Neurotic Personality Trait and Elder Abuse: Investigating the Moderating Role of Change in the Level of Caregiver Perceived Burden. Gerontology 2021; 67:243-254. [PMID: 33454703 DOI: 10.1159/000512238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 10/13/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To investigate whether caregiver neuroticism affects the level of elder abuse and whether changes of caregiver perceived burden alter this relationship. METHODS Using 2-year longitudinal data, a consecutive sample of 800 Chinese family caregivers and their care recipients with dementia were recruited from the geriatric and neurological departments of 3 grade-A hospitals in the People's Republic of China. All the participatory dyads were assessed between September 2015 and February 2016 and followed up for 2 years. RESULTS Significant increase in the prevalence was found for physical abuse, psychological abuse, and caregiver neglect. Caregiver neuroticism was associated with an increased level of physical and psychological abuse over the 2-year observation period; however, change in the level of caregiver perceived burden altered this association. Specifically, the absence and decrease of perceived care burden prevented an increase in the level of physical and psychological abuse among caregivers high in neuroticism. Although caregiver neuroticism was also associated with an increased level of caregiver neglect, caregiver perceived burden did not appear to have an impact on this relationship. DISCUSSION This study provided evidence that caregiver neuroticism was associated with an increased level of physical and psychological abuse, while changes in the level of caregiver perceived burden may alter this trajectory. These findings suggest the importance of implementing caregiver-centered intervention and prevention programs for elder abuse by specifically targeting caregivers' behaviors related to their neurotic personality trait and cognitive appraisal of caregiving stressors associated with such personality traits.
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Affiliation(s)
- Boye Fang
- School of Sociology and Anthropology, Sun Yat-Sen University, Guangzhou, China,
| | - Elsie Yan
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - Xiaozhao Yang
- School of Sociology and Anthropology, Sun Yat-Sen University, Guangzhou, China
| | - Yaolin Pei
- Rory Meyers College of Nursing, New York University, New York, New York, USA
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12
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Fang B, Yan E, Tung K, Liu Z, Ip P. Association between elder abuse and telomere shortening in older adults: A 2-year prospective study. Int J Geriatr Psychiatry 2021; 36:54-63. [PMID: 32748415 DOI: 10.1002/gps.5390] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 07/04/2020] [Accepted: 07/21/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUNDS Elder abuse is a public health issue associated with increased morbidity and mortality. Its impact on victims' health at the cellular level, however, remains unknown. This study assessed the association between abuse exposure and shortening of telomere length (TL), a promising molecular marker for biological aging, in older victims. SETTING The geriatric departments of three Grade-A hospitals in the People's Republic of China (PRC). PARTICIPANTS Six hundred Chinese older adults, including 300 abused victims and 300 non-abused controls were randomly drawn respectively from a larger sample of 467 abused and 518 non-abused older adults recruited at baseline. Participants were assessed for physical and psychological abuse exposure at baseline between September 2015 and February 2016 and assessed for TL 2 years after the abuse assessment. MEASUREMENTS TL was quantified using a quantitative PCR method and expressed as T/S ratio (the ratio of telomere repeat copy numbers to single-copy gene numbers). Physical and psychological abuse was measured using the Revised Conflicts Tactics Scale. RESULTS Adjusting for demographic, medical, and behavioral confounders, physical and psychological abuse exposure at baseline were independently associated with shorter TL at follow-up. The association was the most significant between multiple forms of abuse (physical and psychological) exposure and shorter TL. CONCLUSION This study provides the first evidence on the relationship between abuse and shortened TL in older victims, implying the potential effect of elder abuse on accelerated cellular aging. The findings suggest the importance of routinely assessing and intervening abuse in older adults by healthcare professionals, to promote and maintain physical health in older adults.
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Affiliation(s)
- Boye Fang
- School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, China
| | - Elsie Yan
- Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong, China
| | - Keith Tung
- Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Zuyun Liu
- School of Medicine, Zhejiang University, Zhejiang, China
| | - Patrick Ip
- Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
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Chao YY, Li M, Lu SE, Dong X. Elder mistreatment and psychological distress among U.S. Chinese older adults. J Elder Abuse Negl 2020; 32:434-452. [PMID: 32886054 DOI: 10.1080/08946566.2020.1814180] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study aimed to examine the associations between different types of elder mistreatment, anxiety symptoms, and depressive symptoms among U.S. Chinese older adults. METHODS Data were derived from the Population Study of Chinese Elderly (PINE), a study of Chinese older adults aged 60 years and above in the greater Chicago area from 2011-2013. Measurements include elder mistreatment screening tools, Hospital Anxiety and Depression Scale, and Patient Health Questionnaire-9. Negative binomial regressions and logistic regressions were performed. RESULTS Participants with any mistreatment, psychological mistreatment, physical mistreatment, financial exploitation, and caregiver neglect were more likely to have anxiety symptoms and depressive symptoms. Sexual mistreatment was not associated with symptoms of anxiety and depression. CONCLUSION AND IMPLICATIONS The rate of psychological distress differs based on the types of mistreatment among U.S. Chinese older adults. The findings underline the need for public and community awareness and improved education for health care professionals.
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Affiliation(s)
- Ying-Yu Chao
- School of Nursing, Rutgers, the State University of New Jersey , Newark, New Jersey, USA.,Health Care Policy and Aging Research, Rutgers Institute for Health , New Brunswick, New Jersey, USA
| | - Mengting Li
- School of Nursing, Rutgers, the State University of New Jersey , Newark, New Jersey, USA.,Health Care Policy and Aging Research, Rutgers Institute for Health , New Brunswick, New Jersey, USA
| | - Shou-En Lu
- School of Public Health, Rutgers, the State University of New Jersey , Piscataway, New Jersey, USA
| | - XinQi Dong
- Health Care Policy and Aging Research, Rutgers Institute for Health , New Brunswick, New Jersey, USA
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14
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Subjective cognitive decline and elder mistreatment in Mexican community-dwelling older adults. Arch Gerontol Geriatr 2020; 92:104242. [PMID: 33010789 DOI: 10.1016/j.archger.2020.104242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 07/28/2020] [Accepted: 08/21/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVES Elder mistreatment in individuals with subjective cognitive decline is an understudied public health problem that violates human rights. DESIGN AND METHODS Cross-sectional study of 386 Mexican community-dwelling older adults. Individuals with episodic memory, executive function, language, visuospatial skills or attention cognitive complaints without low cognitive performance scores in the Mini-Mental State Examination and the Isaacs Set Test that were considered positive for subjective cognitive decline (SCD). Elder mistreatment (EM) was considered positive if any of the questions on the Geriatric Mistreatment Scale were answered affirmatively. Logistic regression models were created to test the association between SCD and EM. RESULTS After adjustments made by age, sex, education and depressive symptoms a positive association was found between SCD and EM (OR = 2.226; 95%CI = 1.296 to 3.822 ; p = 0.004). This association was observed in all subtypes of cognitive complaints except excecutive function: episodic memory (OR = 2.219 ; 95%CI = 1.321 to 3.728 ; p = 0.003), language (OR = 2.500 ; 95% CI = 1.422 to 4.396 ; p = 0.001), visuospatial (OR = 2.158 ; 95%CI = 1.162 to 4.007 ; p = 0.015), attention (OR = 2.197 ; 95%CI = 1.206 to 4.001 ; p = 0.010) and executive (OR = 1 2.062 ; 95%CI = 0.981 to 4.333 ; p = 0.056). Discussion and Implications: This study brings to light the relation between SCD and EM in a population where it has been understudied. Exploring mistreatment in older adults who experience subjective cognitive decline might help preserve their safety and create future prevention and intervention strategies.
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Hazrati M, Mashayekh M, Sharifi N, Motalebi SA. Screening for domestic abuse and its relationship with demographic variables among elderly individuals referred to primary health care centers of Shiraz in 2018. BMC Geriatr 2020; 20:291. [PMID: 32807091 PMCID: PMC7430016 DOI: 10.1186/s12877-020-01667-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 07/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Elder abuse is an important public health problem. The present study was aimed to determine the rate of domestic abuse and its relationship with demographic characteristics among elderly people referred to Primary Health Care (PHC) centers in Shiraz, Iran, 2018. METHODS This descriptive and cross-sectional study was conducted on 400 older people aged 60 years old and above who referred to 22 PHC centers of Shiraz. The data were collected using demographic characteristics questionnaire, Katz index, the domestic elder abuse questionnaire, and elder neglect checklist through face-to-face interview and observation methods. Backward linear regression model was used for analyzing the data. RESULTS The results indicated that 52.5% of the participants were female and 51.8% aged 60-69 years old. A total of 159 cases (39.8%) reflected at least one form of elder abuse or neglect. The results indicated that 21% of the participants (n = 84) were abused by their own children. Care neglect was the most reported form (42.8%), followed by psychological abuse (41.3%), emotional neglect (38.8%), and financial abuse (34.3%). The most common types of neglect were motion limitations (25%) followed by the dental problems (23.8%). The results also showed a significant relationship between domestic elder abuse and level of income (p = 0.017), having a house (p = 0.028), type of perpetrator (< 0.001), and insurance status (p = 0.027). CONCLUSIONS The results revealed a considerable rate of domestic abuse against elderly people, causing a serious risk for their health and security.
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Affiliation(s)
- Maryam Hazrati
- Deputy Ministry of Nursing Affairs, Ministry of Health and Medical Education, Tehran, Iran.
- Community Based Psychiatric Care, Research Center, , Shiraz University of Medical Sciences (SUMS), Shiraz, Iran.
| | - Maryam Mashayekh
- Fatemeh Zahra School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nasrin Sharifi
- Epidemiology, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyedeh Ameneh Motalebi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
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