The mortality of elder mistreatment
The mortality of elder mistreatment
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DOI：
10.1001/jama.280.5.428
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发表时间：
1998-08-05
影响因子：
120.7
通讯作者：
Charlson, ME
中科院分区：
文献类型：
--
作者：
Lachs, MS;Williams, CS;Charlson, ME
上下文- 虽然在某些情况下，虐待老年人被怀疑会危及生命，但人们对遭受虐待的老年人的生存情况知之甚少。- 在社区居住的老年人观察队列中，估计报告的虐待和忽视老年人对全因死亡率的独立贡献。- 前瞻性队列研究，至少随访9年。- 纽黑文老年人队列流行病学研究的既定人群，其中包括1982年2812名65岁以上的社区居住成年人，其中一部分人被转介到老年人保护服务机构。主要结果指标。- 全因死亡率在（1）老年人的保护服务被用于证实老年虐待（老年虐待，忽视和/或剥削），或（2）老年人的保护服务被用于自我忽视。- 在队列成立后的前9年，有176名队列成员被老年人保护服务部门核实指控;其中10人（5.7%）被虐待，30人（17.0%）被忽视，8人（4.5%）被剥削，128人（72.7%）被自我忽视。从队列开始的13年随访期结束时，在随访期间任何时候被视为老年虐待的队列成员的生存率（9%）低于自我忽视（17%）或其他未调查的队列成员（40%）（P <0.001），在调整人口统计学特征、慢性疾病、功能状态、社交网络、认知状态的汇总logistic回归中，和抑郁性精神病学，与队列中的其他成员相比，队列成员经历老年虐待（优势比，3.1; 95%可信区间，1.4-6.7）或自我忽视（优势比，1.7; 95%可信区间，1.2-2.5）的死亡风险仍然升高。- 在调整了与老年人死亡率增加相关的其他因素后，报告和证实的老年人虐待和自我忽视与生存期缩短相关。
Context. - Although elder mistreatment is suspected to be life threatening in some instances, little is known about the survival of elderly persons who have been mistreated.Objective. - To estimate the independent contribution of reported elder abuse and neglect to all-cause mortality in an observational cohort of community-dwelling older adults.Design. - Prospective cohort study with at least 9 years of follow-up.Setting and Patients. - The New Haven Established Population for Epidemiologic Studies in the Elderly cohort, which included 2812 community-dwelling adults who were older than 65 years in 1982, a subset of whom were referred to protective services for the elderly.Main Outcome Measures. - All-cause mortality among (1) elderly persons for whom protective services were used for corroborated elder mistreatment (elder abuse, neglect, and/or exploitation), or (2) elderly persons for whom protective services were used for self-neglect.Results. - In the first 9 years after cohort inception, 176 cohort members were seen by elderly protective services for verified allegations; 10 (5.7%) of these were for abuse, 30 (17.0%) for neglect, 8 (4.5%) for exploitation, and 128 (72.7%) for self-neglect. At the end of a 13-year follow-up period from cohort inception, cohort members seen for elder mistreatment at any time during the follow-up had poorer survival (9%) than either those seen for self-neglect (17%) or other noninvestigated cohort members (40%) (P < .001), In a pooled logistic regression that adjusted for demographic characteristics, chronic diseases, functional status, social networks, cognitive status, and depressive symptomatology, the risk of death remained elevated for cohort members experiencing either elder mistreatment (odds ratio, 3.1; 95% confidence interval, 1.4-6.7) or self-neglect (odds ratio, 1.7; 95% confidence interval, 1.2-2.5), when compared with other members of the cohort.Conclusions. - Reported and corroborated elder mistreatment and self-neglect are associated with shorter survival after adjusting for other factors associated with increased mortality in older adults.