Association Between Different Forms of Elder Mistreatment and Cognitive Change

Risk Factors for Post-Discharge Adverse Outcomes Following Hospitalization Among Older Adults Diagnosed With Elder Mistreatment

Using 100% Medicare data files, this study explored whether primary elder mistreatment (EM) diagnosis, EM type, and facility type were associated with 3-year mortality and 1-year unplanned hospital readmission among older patients diagnosed with EM with hospital discharge from 10/01/2015 through 12/31/2018 (n = 11,023). We also examined outcome differences between older patients diagnosed with EM and matched non-EM patient controls. Neglect by others was the most common EM diagnosis. Three-year mortality was 56.7% and one-year readmission rate was 53.8%. Compared to matched non-EM patient controls, older EM patients were at an increased risk of mortality and readmission. Among patients diagnosed with EM, patients with a secondary (vs. primary) diagnosis and those discharged from a skilled nursing facility (vs. acute hospital) were at an increased risk for both mortality and readmission. Compared to other EM types, patients diagnosed with neglect by others had a greater risk for mortality following discharge.

Elder abuse and depressive symptoms among older adults in China: The moderating role of adverse childhood experiences

BACKGROUND

This study aimed to examine: (a) the associations between elder abuse and depressive symptoms among older adults in China, and (b) the moderating role of adverse childhood experiences (ACEs) on the relationships between elder abuse and its subtypes and depressive symptoms.

METHODS

This study used the cross-sectional data from the 2018 China Longitudinal Aging Social Survey (N = 8436, mean age = 71.3, 49.3 % female). Depressive symptoms were measured as CES-D scale. Elder abuse was evaluated by physical abuse, emotional abuse, and financial exploitation. ACEs were assessed via hunger, inadequate medical care, and death of parent(s) during childhood. Multiple linear regression models and interaction terms were used.

RESULTS

Elder abuse was significantly associated with increased depressive symptoms. Regarding elder abuse subtypes, when physical abuse, emotional abuse, and financial exploitation were included separately in regression models, they were all associated with increased depression. However, when all three subtypes were included simultaneously, only emotional abuse remained related to higher depression. Furthermore, ACEs acted as a moderator in the link between elder abuse and depressive symptoms. Specifically, moderate exposure to ACEs (exposure to one or two ACEs) attenuated the detrimental impacts of elder abuse on depression. For elder abuse subtypes, one and two ACEs alleviate the adverse effects of financial exploitation on depressive symptoms.

LIMITATIONS

Cross-sectional design is the major limitation.

CONCLUSIONS

The findings highlight the importance of considering the moderating role of ACEs when examining the association between elder abuse and depressive symptoms in later life.

Elder abuse and cognitive function among community-Dwelling older adults: Does abuse history matter?

BACKGROUND AND AIM

The World Health Organization has identified child abuse, intimate partner violence (IPV), and elder abuse (EA) as common types of interpersonal violence. Research showed individuals exposed to interpersonal violence in one life stage were at higher risks of exposure to interpersonal violence in other life stages. This study aims to examine the relationship between cumulative interpersonal violence and cognitive function.

METHODS

Data were derived from the PINE Study in which 3,157 Chinese older adults aged 60 and above received interviews in Chicago. We used a 56-item modified Conflict Tactics Scale to evaluate EA. Abuse history was defined as exposure to child abuse (before age 18) and/or IPV (age 18-59) measured respectively by the Extended Hurt, Insult, Threaten, Scream scale. We divided participants into four groups: EA and abuse history (n = 204), EA only (n = 439, reference group), abuse history only (n = 310), and no interpersonal violence (n = 2181). Global cognition was evaluated by episodic memory, working memory, processing speed, and MMSE. Linear regression was used.

RESULTS

Older adults with EA and abuse history (b = 0.147, SE = 0.052, p < .01) or abuse history only (b = 0.118, SE = 0.046, p < .01) had higher global cognition than the EA only group.

CONCLUSIONS

Individuals with abuse history might develop resilience in the face of interpersonal violence in old age through gaining a sense of mastery and developing effective coping skills from prior experience. Healthcare professionals could assess older adults' prior victimizations and recent victimizations to plan family violence counseling and promote healthy cognitive aging.