The Mortality of Elder Mistreatment | Geriatrics | JAMA | JAMA Network
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1.
Johnson T. Elder Mistreatment: Deciding Who Is at Risk . Westport, Conn: Greenwood Press; 1991.
2.
Lachs MS, Williams C, O'Brien S, Hurst L, Horwitz R. Older adults: an 11-year longitudinal study of adult protective service use.  Arch Intern Med.1996;156:449-453.Google Scholar
3.
Lachs MS, Williams C, O'Brien S, Hurst L, Horowitz R. Risk factors for reported elder abuse and neglect: a nine year observational cohort study.  Gerontologist.1997;37:469-474.Google Scholar
4.
Pillemer KA, Finkelhor D. The prevalence of elder abuse: a random sample survey.  Gerontologist.1988;28:51-57.Google Scholar
5.
Lachs MS, Berkman L, Fulmer T, Horowitz RI. A prospective community-based pilot study of risk factors for the investigation of elder mistreatment.  J Am Geriatr Soc.1994;42:169-173.Google Scholar
6.
National Institute on Aging.  Established Populations for Epidemiologic Studies of the Elderly: Resource Data Book . Washington, DC: US Dept of Health and Human Services; 1986. NIA publication 86-2443.
7.
Cornoni-Huntley J, Ostfeld AM, Taylor JO.  et al.  Established populations for epidemiologic studies of the elderly: study design and methodology.  Aging (Milano).1993;5:27-37.Google Scholar
8.
Shah BV, Barnwell BG, Bieler GS. SUDAAN User's Manual, Release 7.0 . Research Triangle Park, NC: Research Triangle Institute; 1996.
9.
Rosow I, Breslau N. A Guttman health scale for the aged.  J Gerontol.1966;21:556-559.Google Scholar
10.
Nagi SZ. An epidemiology of disability among adults in the United States.  Milbank Mem Fund Q Health Soc.1976;54:439-468.Google Scholar
11.
Pfeiffer E. A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients.  J Am Geriatr Soc.1975;23:433-441.Google Scholar
12.
Radloff LS. The CES-D scale: a self-report depression scale for research in the general population.  Appl Psychol Meas.1977;1:385-401.Google Scholar
13.
Cupples LA, D'Agostio RB, Anderson K, Kannel WB. Comparison of baseline and repeated measure covariate techniques in the Framingham Heart Study.  Stat Med.1988;7:205-218.Google Scholar
14.
Fiore J, Becker J, Coppel DB. Social network interactions: a buffer or a stress?  Am J Community Psychol.1983;11:423-439.Google Scholar
15.
Okun MA, Melichar JF, Hill MD. Negative daily events, positive and negative social ties, and psychological distress among older adults.  Gerontologist.1990;30:193-199.Google Scholar
16.
Pillemer K, Suitor JJ. Family stress and social support among caregivers to persons with Alzheimer's disease. In: Pierce GR, Sarason BR, Sarason IG, eds. Handbook of Social Support and Family . New York, NY: Plenum; 1996:467-494.
17.
Rook K. The negative side of social interactions: impact on psychological well-being.  J Pers Soc Psychol.1984;46:1097-1108.Google Scholar
18.
Vinocur AD, van Ryn M. Social support and undermining in close relationships: their independent effects on the mental health of unemployed persons.  J Pers Soc Psychol.1993;65:350-359.Google Scholar
19.
Pillemer KA, Suitor JJ. Violence and violent feelings: what causes them among family caregivers?  J Gerontol.1992;47:S165-S172.Google Scholar
Original Contribution
August 5, 1998

The Mortality of Elder Mistreatment

Author Affiliations

From the Divisions of Geriatrics and Gerontology (Dr Lachs) and General Internal Medicine (Dr Charlson), Cornell University Medical College, New York, NY; the Departments of Medicine and Epidemiology, Yale University School of Medicine, New Haven, Conn (Ms Williams); the Connecticut Department of Social Services, Hartford (Ms O'Brien); and the Cornell College of Human Ecology, Ithaca, NY (Dr Pillemer).

JAMA. 1998;280(5):428-432. doi:10.1001/jama.280.5.428
Abstract

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.

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