Syndemics of Severity and Frequency of Elder Abuse: A Cross-Sectional Study in Mexican Older Females.

Mireya Vilar-Compte,Pablo Gaitán-Rossi

doi:10.3389/fpsyt.2018.00599

Mireya Vilar-Compte, Pablo Gaitán-Rossi

Open Access

https://doi.org/10.3389/fpsyt.2018.00599

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Abstract

Background: Elder abuse is a common phenomenon with important effects on the health and well-being of older adults. There are important gaps in elder abuse measurement, as it is usually reported as the absence or presence of elder abuse, disregarding its severity and frequency.Objectives: Identify different ways of measuring severity and frequency of elder abuse and assess whether different experiences of severity and frequency suggest syndemic relationships.Methods: Through a sample of 534 non-institutionalized Mexican older women, we assessed how severity (i.e., number of abusive experiences and number of types of abuses) and frequency (i.e., if abusive experiences had happened few or many times) correlate among them. For each of these measures we estimated a multinomial model to examine associations with social support, functional impairments, socioeconomic status, food insecurity, depression, and comorbidities, while controlling for key socio-demographic variables.Results: 30.5% of the older women reported psychological abuse, 8.2% financial exploitation, 5.1% caregiver neglect, 3.5% physical abuse, and 1.2% sexual abuse. In terms of frequency, 77.8% of the women self-reported having never been abused or only once in the last 12 months, whereas 13.1% reported abusive experiences repeating few times, and 9.9% repeating many times. In terms of severity, 66.7% of the older women had not been abused, 22.3% had suffered one type of abuse, and 11.1% two or more. Similarly, 15.0% reported one abusive experience, 8.1% two, and 10.3% three or more abusive events during the last 12 months. Severity measures showed similar associations: social support and high socioeconomic level as protective factors among those with less severe abuse, whereas increased depression, food insecurity and functional impairments were associated with more severe experiences of elder abuse. Frequency followed a different pattern, depressive symptoms were significantly associated with those with few experiences (compared to those with none or once), while functional impairments were associated with many experiences of elder abuse.Conclusions: It is relevant to assess elder abuse through its severity and frequency as inter-individual variability and the complexity of the experience shows different determinants suggesting a syndemic approach. This has important clinical and policy implications.

Highlights

The World Health Organization (WHO) defines elder abuse as a “single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person” [1]
In terms of psychosocial resources, it has been reported that older adults with fewer resources are more vulnerable to abuse and, at the same time, abuse seems to be detrimental to psychological well-being [5, 6]
Data was obtained from a cross-sectional study of older adults who assist to the network of community centers from the Mexican National Institute for Older Adults (INAPAM for its acronym in Spanish)

Summary

Introduction

The World Health Organization (WHO) defines elder abuse as a “single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person” [1]. According to a recent metaanalysis, prevalence of elder abuse in community settings is 1 in 6 elder adults worldwide, which accounts for ≈141 million people [2]. This is alarming as the literature suggests that elder abuse is associated with increased risk of morbidity and mortality, institutionalization and hospitalization [3], and has negative effects on families and communities [2]. In terms of psychosocial resources (i.e., social networks, social support, coping resources), it has been reported that older adults with fewer resources are more vulnerable to abuse and, at the same time, abuse seems to be detrimental to psychological well-being [5, 6]. There are important gaps in elder abuse measurement, as it is usually reported as the absence or presence of elder abuse, disregarding its severity and frequency

Objectives

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Conclusion