Risk Factors for Reported Elder Abuse and Neglect: A Nine-Year Observational Cohort Study

TLDR

The study notes that using protective services for case‑finding may overestimate race and poverty as risk factors because of reporting bias. The study aimed to identify longitudinal risk factors for elder abuse and neglect by linking a cohort of 2,812 community‑dwelling older adults to protective service records over nine years. The authors linked the 2,812‑person cohort to protective service records and followed participants for nine years. Over nine years, 6.5% of participants had any protective service contact and 1.6% had corroborated elder abuse or neglect, with age, race, poverty, functional disability, cognitive impairment, and new cognitive decline identified as risk factors.

Abstract

To determine longitudinal risk factors for elder abuse and neglect, an established cohort of community-dwelling older adults (n = 2,812) was linked with elderly protective service records over a 9-year follow-up period. Protective services saw 184 (6.5%) individuals in the cohort for any indication, and 47 cohort members were seen for corroborated elder abuse or neglect for a sampling adjusted 9-year prevalence of 1.6% (95% Cl 1.0%, 2.1%). In pooled logistic regression, age, race, poverty, functional disability, and cognitive impairment were identified as risk factors for reported elder mistreatment. Additionally, the onset of new cognitive impairment was also associated with elder abuse and neglect. Because the mechanism of elder mistreatment case-finding in this study was a social welfare system (protective services), the influence of race and poverty as risk factors is likely to be overestimated due to reporting bias.