Background Current knowledge about elder mistreatment is mainly derived from studies done in Western countries, which indicate that this problem is related to risk factors such as a shared living situation, social isolation, disease burden, and caregiver strain. We know little about prevalence and risk factors for elder mistreatment and mistreatment subtypes in rural China where the elder population is the most vulnerable. Methods In 2010, we conducted a cross-sectional survey among older adults aged 60 or older in three rural communities in Macheng, a city in Hubei province, China. Of 2245 people initially identified, 2039 were available for interview and this was completed in 2000. A structured questionnaire was used to collect data regarding mistreatment and covariates. Logistic regression analysis was used to identify factors related to elder mistreatment and subtypes of mistreatment. Results Elder mistreatment was reported by 36.2% (95% CI: 34.1%–38.3%) of the participants. Prevalence rates of psychological mistreatment, caregiver neglect, physical mistreatment, and financial mistreatment were 27.3% (95% CI: 25.3%–29.2%), 15.8% (95% CI: 14.2%–17.4%), 4.9% (95% CI: 3.9%–5.8%) and 2.0% (95% CI: 1.3%–2.6%), respectively. The multivariate logistic regression analysis revealed that depression, being widowed/divorced/single/separated, having a physical disability, having a labor intensive job, depending solely on self-made income, and living alone were risk factors for elder mistreatment. Different types of elder mistreatment were associated with different risk factors, and depression was the consistent risk factor for the three most common mistreatment subtypes. Conclusion Older adults in rural China self-report a higher rate of mistreatment than their counterparts in Western countries. Depression is a main risk factor associated with most subtypes of mistreatment. Our findings suggest that prevention and management of elder mistreatment is a challenge facing a rapidly aging Chinese population.
References
[1]
Dong X (2005) Medical implications of elder abuse and neglect. Clin Geriatr Med 21: 293–313.
[2]
Lachs MS, Williams CS, O'Brien S, Pillemer KA, Charlson ME (1998) The mortality of elder mistreatment. JAMA 280: 428–432.
[3]
Bonnie RJ, Wallace RB (2003) Elder mistreatment: Abuse, neglect and exploitation in an aging America;. In: Wallace RB, editor. Washington, DC: National Academies Press. 34 p.
[4]
Thomas C (2000) The First National Study of Elder Abuse and Neglect: contrast with results from the other studies. J Elder Abuse Negl 12: 1–14.
[5]
Lachs MS, Pillemer K (2004) Elder abuse. Lancet 364: 1263–1272.
[6]
Dong X, Simon MA, Gorbien M (2007) Elder abuse and neglect in an urban Chinese population. Elder Abuse Negl 19: 79–96.
[7]
Dong X, Chang E, Wong E, Wong B, Simon MA (2011) How do US Chinese older adults view elder mistreatment? Findings from a community-based participatory research study. J Aging Health 23: 289–312.
[8]
Yan E, Tang CS, Yeung D (2002) No Safe Haven: A Review on Elder Abuse in Chinese Families. Trauma Violence Abuse 3: 167–180.
[9]
Hwalek MA, Sengstock MC (1986) Assessing the probability of abuse in the elderly: Toward development of a clinical screening instrument. J Appl Gerontol 5: 153–173.
[10]
Schofield MJ, Mishra GD (2003) Validity of self-report screening scale for elder abuse: Women's Health Australia Study. Gerontologist 43: 110–120.
[11]
Burke WJ, Roccaforte WH, Wengel SP (1991) The short form of the Geriatric Depression Scale : a comparison with the 30-item form. Geriat Psychiatry Neurol 4: 173–178.
[12]
Lam TH, Li ZB, Ho SY, Chan WM, Ho KS, et al. (2004) Smoking and depressive symptoms in Chinese elderly in Hong Kong. Acta Psychiatr Scand 110: 195–200.
[13]
Boey KW (2000) The Use of GDS-15 Among the Older Adults in Beijing Clinical. Gerontologist 21: 49–60.
[14]
Acierno R, Hernandez MA, Amstadter AB, Resnick HS, Steve K, et al. (2010) Prevalence and correlates of emotional, physical, sexual, and financial abuse and potential neglect in the United States: the National Elder Mistreatment Study. Am J Public Health 100: 292–297.
[15]
Laumann EO, Leitsch SA, Waite LJ (2008) Elder mistreatment in the United States: prevalence estimates from a nationally representative study. J Gerontol B Psychol Sci Soc Sci 63: S248–S254.
[16]
Cooper C, Selwood A, Livingston G (2008) The prevalence of elder abuse and neglect: a systematic review. Age Ageing 37: 151–160.
[17]
Cohen M, Levin SH, Gagin R, Friedman G (2007) Elder abuse: disparities between older people's disclosure of abuse, evident signs of abuse, and high risk of abuse. J Am Geriatr Soc 55: 1224–1230.
[18]
Dong X, Simon MA, Odwazny R, Gorbien M (2008) Depression and elder abuse and neglect among a community-dwelling Chinese elderly population. J Elder Abuse Negl 20: 25–41.
[19]
Lachs MS, Williams C, O'Brien S, Hurst L, Horwitz R (1997) Risk factors for reported elder abuse and neglect: a nine-year observational cohort study. Gerontologist 37: 469–474.
[20]
Paveza GJ, Cohen D, Eisdorfer C, Freels S, Semla T, et al. (1992) Severe family violence and Alzheimer's disease: prevalence and risk factors. Gerontologist 32: 493–497.
[21]
Pillemer K, Finkelhor D (1988) The prevalence of elder abuse: a random sample survey. Gerontologist 28: 51–57.
[22]
Silverstein M, Cong Z, Li S (2006) Intergenerational transfers and living arrangements of older people in rural China: consequences for psychological well-being. J Gerontol B Psychol Sci Soc Sci 61: S256–266.
[23]
Chen F, Short SE (2008) Household Context and Subjective Well-Being Among the Oldest Old in China. J Fam Issues 29: 1379–1403.
[24]
Perez-Rojo G, Izal M, Montorio I, Penhale B (2009) Risk factors of elder abuse in a community dwelling Spanish sample. Arch Gerontol Geriatr 49: 17–21.
[25]
Greenberg JR, McKibben M, Raymond JA (1990) Dependent adult children and elder abuse. J Elder Abuse Negl 2: 73–86.
[26]
Yan E, Tang CS (2001) Prevalence and psychological impact of Chinese elder abuse. J Interpers Violence 16: 1158–1174.
[27]
Cham GW, Seow E (2000) The pattern of elderly abuse presenting to an emergency department. Singapore Med J 41: 571–574.
[28]
Zeng Y, Liu YZ, George LK (2003) Gender differentials of the oldest old in China. Res Aging 25: 65–80.
[29]
Dong X, Beck T, Simon MA (2010) The associations of gender, depression and elder mistreatment in a community-dwelling Chinese population: the modifying effect of social support. Arch Gerontol Geriatr 50: 202–208.
[30]
Fulmer T (2002) Elder mistreatment. Annu Rev Nurs Res 20: 369–395.
[31]
Garre-Olmo J, Planas-Pujol X, Lopez-Pousa S, Juvinya D, Vila A, et al. (2009) Prevalence and risk factors of suspected elder abuse subtypes in people aged 75 and older. J Am Geriatr Soc 57: 815–822.
[32]
Compton SA, Flanagan P, Gregg W (1997) Elder abuse in people with dementia in Northern Ireland: prevalence and predictors in cases referred to a psychiatry of old age service. Int J Geriatr Psychiatry 12: 632–635.
[33]
Reay AM, Browne KD (2001) Risk factor characteristics in carers who physically abuse or neglect their elderly dependents. Aging Ment Health 5: 56–62.
