Elder Abuse and Mortality: The Role of Psychological and Social Wellbeing
Elder Abuse and Mortality: The Role of Psychological and Social Wellbeing
复制标题
DOI：
10.1159/000321881
复制
发表时间：
2011-01-01
期刊：
影响因子：
3.5
通讯作者：
Evans, D. A.
中科院分区：
文献类型：
--
作者：
Dong, X. Q.;Simon, M. A.;Evans, D. A.
背景：虐待老年人是一个普遍存在的人权和公共卫生问题。目的：我们的目的是在心理和社会因素的水平上检查与老年人虐待相关的死亡率。方法：芝加哥健康与老龄化项目（CHAP）是一项始于1993年的前瞻性人群队列研究。这些参与者中有一部分在1993年至2005年期间向社会服务机构报告了虐待老年人的情况（n = 113）。死亡率是通过随访和国家死亡指数确定的。在CHAP访谈中评估心理社会因素（抑郁、社会网络和社会参与）。采用Cox比例风险模型，采用时变协变量分析，评估不同社会心理因素水平下虐待老年人的死亡率。结果：该队列（n = 7841）的中位随访时间为7.6年（四分位数间距为3.8-12.4年）。在多变量分析中，抑郁症状最高（风险比2.60,95% CI 1.58-4.28）和中等水平（风险比2.18,95% CI 1.19-3.99）的患者与虐待老人相关的死亡风险增加。在社会网络方面，社会网络最低（HR 2.50, 95% CI 1.62-3.87）和中等（HR 2.65, 95% CI 1.52-4.60）的人与虐待老人相关的死亡风险增加。在社会参与方面，社会参与最低（HR 2.32, 95% CI 1.47-3.68）和中等（HR 2.59, 95% CI 1.65-5.45）的人与虐待老人相关的死亡风险增加。在那些抑郁症状程度最低、社交网络和社会参与程度最高的人中，报告或证实的虐待老年人对死亡风险没有显著影响。结论：在抑郁症状程度较高、社交网络和社会参与程度较低的老年人中，与虐待老年人相关的死亡风险最为突出。版权所有：S. Karger AG，巴塞尔
Background: Elder abuse is a pervasive human right and public health issue. Objectives: We aimed to examine the mortality associated with elder abuse across levels of psychological and social factors. Methods: The Chicago Health and Aging Project (CHAP) is a prospective population-based cohort study that began in 1993. A subset of these participants enrolled between 1993 and 2005 had elder abuse reported to social services agencies (n = 113). Mortality was ascertained during follow-up and with the National Death Index. Psychosocial factors (depression, social network and social engagement) were assessed during the CHAP interview. Cox proportional hazard models were used to assess the mortality of elder abuse across levels of psychosocial factors using time-varying covariate analyses. Results: The median follow-up time for the cohort (n = 7,841) was 7.6 years (interquartile range 3.8-12.4 years). In multivariate analyses, those with highest (hazard ratio (HR) 2.60, 95% CI 1.58-4.28) and middle levels (HR 2.18, 95% CI 1.19-3.99) of depressive symptoms had an increased mortality risk associated with elder abuse. For social network, those with lowest (HR 2.50, 95% CI 1.62-3.87) and middle levels (HR 2.65, 95% CI 1.52-4.60) of social network had increased mortality risk associated with elder abuse. For social engagement, those with lowest (HR 2.32, 95% CI 1.47-3.68) and middle levels (HR 2.59, 95% CI 1.65-5.45) of social engagement had increased mortality risk associated with elder abuse. Among those with lowest levels of depressive symptoms, highest levels of social network and social engagement, there was no significant effect of reported or confirmed elder abuse on mortality risk. Conclusion: Mortality risk associated with elder abuse was most prominent among those with higher levels of depressive symptoms and lower levels of social network and social engagement. Copyright (C) 2010 S. Karger AG, Basel