Abstract
BackgroundCurrent 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.MethodsIn 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.ResultsElder 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.ConclusionOlder 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.
Highlights
Elder mistreatment is an important public health issue, and prior studies have suggested that such mistreatment can cause significant adverse health outcomes [1,2]
The National Research Council (NRC) report ‘‘Elder Mistreatment: Abuse, Neglect and Exploitation in an Aging America’’ defined elder mistreatment as ‘‘intentional actions that cause harm or create a serious risk of harm, whether or not intended, to a vulnerable elder by a caregiver or other person who stands in a trust relationship to the elder or failure by a caregiver to satisfy the elder’s basic needs or to protect the elder from harm’’ [3]
Most Chinese elderly people rely on their children for care and financial support, especially those in rural areas who have no adequate pension or medical care that is largely available for the urban older people
Summary
Elder mistreatment is an important public health issue, and prior studies have suggested that such mistreatment can cause significant adverse health outcomes [1,2]. The lack of financial support and dependence on children make the rural older people in China a vulnerable population for elder mistreatment. No research about elder mistreatment in rural areas of China has been reported To fill this knowledge gap, we used the definition of elder mistreatment of the National Research Council Panel to Review Risk and Prevalence of Elder Abuse and Neglect to measure elder mistreatment. We examined the prevalence of elder mistreatment as well as possible risk factors and mistreatment subtypes in a rural community of China. 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
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