Elder Self-Neglect & Abuse Linked to Increased Risk of Death
By Richard Shank
A study published in the Journal of the American Medical Association confirmed the link between self-neglect, abuse, and all-cause mortality.
In 2000, an Administration on Aging survey found that reports of self-neglect and abuse were on the rise. As a consequence, elder self-neglect and abuse have become prominent public health concerns. Self-neglect typically involves older adults either refusing or failing to provide themselves food, water, clothing, shelter, personal hygiene, necessary medication, and other safety precautions. Elder abuse ranges from physical and sexual to deprivation, caregiver neglect, and financial exploitation.
Researchers at Rush University utilized data from the Chicago Health and Aging Project (CHAP), a prospective, population-based study of urban-dwelling older adults designed to identify risk factors for Alzheimer’s disease and other chronic age-related health conditions.
The current analysis utilized reports of suspected elder self-neglect or abuse by social service agencies. These reports were collected from a variety of sources, including health care and legal professionals, city workers, community organizations, family, friends, and/or neighbors.
In this study, self-neglect was reported more often than abuse. Cases tended to be older, female, African-American, and having a lower income and education. Of the reported cases, nearly 50% of them had died during the 14-year course of the study. Further results indicated that, when controlling for physical and cognitive functioning, age, income, and education, cases of reported self-neglect or abuse were significantly more likely to die during the course of the study.
These findings suggest that self-neglect and abuse can result in premature death, regardless of physical or cognitive condition. Even more alarming is the fact that this study utilized officially reported cases of self-neglect and abuse. The National Elder Abuse Incidence Study estimates that only one of every 14 cases of elder abuse ever gets reported, and it is suspected that similar numbers of self-neglect go unnoticed.
Agencies working with older adults in the community must consider ways of identifying and responding to cases of self-neglect and abuse.
Source: Dong, X. Simon, M., Mendes de Leon, C., Fulmer, T. et al. 2009. Elder self-neglect and abuse and mortality risk in a community dwelling population. JAMA 302(5): 517-526.
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