Mortality Risk Associated with Physical and Verbal Abuse in Women Aged 50 to 79
Mortality Risk Associated with Physical and Verbal Abuse in Women Aged 50 to 79
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DOI：
10.1111/j.1532-5415.2009.02429.x
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发表时间：
2009-10-01
影响因子：
6.3
通讯作者：
Woods, Nancy F.
中科院分区：
文献类型：
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作者：
Baker, Margaret W.;LaCroix, Andrea Z.;Woods, Nancy F.
目标 调查报告前一年身体虐待、言语虐待或两种虐待类型的中年和老年妇女是否比未报告前一年虐待的同龄人有更高的死亡风险。设计回顾性分析。设置社区。参与者 16万676名基线年龄为 50 至 79 岁的社区居住妇女参加了两项主要妇女健康倡议 (WHI) 研究组成部分之一，她们对基线虐待做出了反应问题。观察性研究入组人数为 N=93,676（1994-1998 年；平均随访 90 个月）。临床试验注册人数为 N=68,132（1993-1998 年；平均随访 96 个月）。 测量 使用所有可用数据源测量 1993 年至 2005 年的总死亡率。盲法医师评审人员测量了特定原因的死亡率。 96% 的死亡记录得到裁决。 结果 往年自我报告的虐待发生率为 11.3%。报告遭受身体虐待的女性的年龄调整死亡率最高，其次是报告两种类型虐待的女性。在控制年龄、教育程度、种族和 WHI 成分后，虐待独立预测死亡风险。调整人口和健康相关因素后，遭受身体虐待的女性仍然存在较高的死亡风险（风险比 (HR)=1.54，95% 置信区间 (CI)=1.09-2.18）。对心理社会变量的进一步调整削弱了这种关联（HR=1.40，95% CI=0.93-2.11），但高风险仍然存在。 结论 报告上一年身体、言语或两种类型虐待的社区居住中年和老年女性的调整后死亡风险显着高于未报告虐待的女性。这些发现强调了对预防晚年虐待和随之而来的死亡率过高进行纵向研究的必要性，并强调了预防晚年虐待的重要性。
OBJECTIVESTo investigate whether midlife and older women who reported prior-year physical abuse, verbal abuse, or both abuse types had higher mortality risk than peers who did not report prior-year abuse.DESIGNRetrospective analysis.SETTINGCommunity.PARTICIPANTSOne hundred sixty-thousand six hundred seventy-six community-dwelling women ages 50 to 79 at baseline enrolled in one of two major Women's Health Initiative (WHI) study components who responded to baseline abuse questions. Observational study enrollment was N=93,676 (1994-1998; 90 months average follow-up). Clinical trial enrollment was N=68,132 (1993-1998; 96 months average follow-up).MEASUREMENTSTotal mortality was measured from 1993 to 2005 using all available data sources. Blinded physician adjudicators measured cause-specific mortality. Ninety-six percent of death records were adjudicated.RESULTSPrior-year self-reported abuse prevalence was 11.3%. Women who reported physical abuse had the highest age-adjusted mortality rate, followed by women who reported both abuse types. Abuse independently predicted mortality risk after controlling for age, education, ethnicity, and WHI component. High mortality risk remained for physically abused women (hazard ratio (HR)=1.54, 95% confidence interval (CI)=1.09-2.18) after adjusting for demographic and health-related factors. Further adjustment for psychosocial variables diminished this association (HR=1.40, 95% CI=0.93-2.11), but high risk remained.CONCLUSIONCommunity-dwelling middle-aged and older women who reported prior-year physical, verbal, or both types of abuse had significantly higher adjusted mortality risk than women who did not report abuse. These findings highlight the need for longitudinal research into prevention of abuse in later life and accompanying excess mortality and emphasize the importance of abuse prevention in later life.