The Prevalence and Associated Factors of Elderly Abuse: A Cross-Sectional Study

Abstract

Objective: The prevalence of elderly abuse varies between 2.2% and 30.1% in European countries. There is a limited number of studies that have investigated elderly abuse in Turkey. The aim of this study is to detect the prevalence and risk factors of elder abuse, identify the factors that can affect elderly abuse, and assess the possible measures to prevent this problem. Methods: We stratified the districts enrolled in family health centers to ensure that participants were from diverse social, cultural, and economic backgrounds of Edirne and formed a representative sample of 211 people. In addition to sociodemographic characteristics, our survey consisted of the Hwalek-Sengstock Elder Abuse Screening Test, the Geriatric Depression Scale-short form, the Standardised Mini-Mental State Examination, the Barthel Index for activities of daily living, and the Lawton-Brody instrumental activities of daily living scale. Results: The prevalence of elderly abuse was determined as 9.9%, and high abuse risk was 15.2%. We found that abuse risk was higher among older people who had no social security, lived alone, were abused physically or emotionally before, reported having bad family relations, and had fewer rooms at home which leads to a lack of privacy. Furthermore, we found significant relationships between abuse risk and the depression score. Conclusion: Elderly abuse is a risk for every person regardless of gender, education level, and economic status. As an invisible problem for societies, elderly abuse brings a great burden by leading to the loss of physical, mental, and psychological health. Preventive measures should be the primary goal. All results suggest that governments, non-governmental organizations, and health care providers should combat this problem by increasing patient literacy and ensuring lifestyle changes.

Keywords

• elderly abuse
• risk factors
• living arrangements
• community health

Yaşlı İstismarı Prevalansı ve Etkileyen Faktörler: Kesitsel Bir Çalışma

Abstract

Amaç: Yaşlı istismarı prevalansı Avrupa ülkelerinde %2,2 ile %30,1 arasında değişmektedir. Türkiye’de yaşlı istismarını inceleyen sınırlı sayıda çalışma mevcuttur. Bu çalışmanın amacı yaşlı istismarı prevalansı ve risk faktörlerini saptamak, yaşlı istismarını etkileyen faktörleri tespit etmek ve nu sorunu önlemek için alınabilecek tedbirleri değerlendirmektir. Gereç ve Yöntem: Katılımcıların tüm sosyal, kültürel ve ekonomik kesimlerden olması için aile sağlığı merkezleri nüfusları üzerinden tabakalandırma yapılarak 211 kişilik örneklem oluşturulmuştur. Sosyodemografik özelliklere ek olarak Hwalek-Sengstock Yaşlı İstismarı Tarama Testi, Geriatrik Depresyon Ölçeği Kısa Formu, Standardize Mini Mental Durum Testi, Barthel Günlük Yaşam Aktiviteleri İndeksi ve Lawton-Brody Enstrümental Günlük Yaşam Aktiviteleri Ölçeği ankete dahil edilmiştir. Bulgular: Yaşlı istismarı prevalansı %9,9 ve yüksek istismar riski %15,2 olarak tespit edilmiştir. Sosyal güvencesi olmayan, yalnız yaşayan, daha önce fiziksel veya duygusal istismara uğramış, aile ilişkilerinin kötü olduğunu bildiren ve mahremiyet eksikliğine yol açacak şekilde evinde az sayıda odası olan yaşlılarda istismar riskinin daha yüksek olduğu tespit edilmiştir. Yapılan regresyon analizinde istismar riski ile depresyon skoru arasında anlamlı ilişki bulunmuştur. Sonuç: Yaşlı istismarı cinsiyet, eğitim düzeyi ve ekonomik durumu ne olursa olsun her insan için bir risktir. Toplumlar için görünmez bir sorun olan yaşlı istismarı, fiziksel, zihinsel ve psikolojik sağlık kaybına yol açarak büyük bir yük getirmektedir. Önleyici tedbirler öncelikli hedef olmalıdır. Tüm sonuçlar hükümetlerin, sivil toplum kuruluşlarının ve sağlık hizmeti sağlayıcılarının hasta okuryazarlığını artırarak ve yaşam tarzı değişiklikleri sağlayarak bu sorunla mücadele etmesi gerektiğini göstermektedir.

Keywords

• yaşlı istismarı
• risk faktörleri
• yaşam düzenlemeleri
• toplum sağlığı

References

1. 1. United Nations. Global issues, ageing [Internet]. USA: United Nations; 2019 [cited 2020 Apr 15]. Available from: https://www.un.org/en/sections/issues-depth/ageing/
2. 2. Lopez AD, Begg S, Bos E. Demographic and epidemiological characteristics of major regions, 1990–2001. In: Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJL, editors. Global burden of disease and risk factors. New York (USA): Oxford University Press; 2006. p. 17-44.
3. 3. Pillemer K, Burnes D, Riffin C, Lachs MS. Elder abuse: global situation, risk factors, and prevention strategies. Gerontologist. 2016;56(Suppl 2):S194-205.
4. 4. Vognar L, Dosa D, Taylor L. The impact of elder abuse on a growing senior veteran population. Fed Pract. 2016;33(8):22-6.
5. 5. Cooper C, Selwood A, Livingston G. The prevalence of elder abuse and neglect: a systematic review. Age Ageing. 2008;37(2):151-60.
6. 6. Teresi JA, Burnes D, Skowron EA, Dutton MA, Mosqueda L, et al. State of the science on prevention of elder abuse and lessons learned from child abuse and domestic violence prevention: Toward a conceptual framework for research. J Elder Abuse Negl. 2016;28(4-5):263-300.
7. 7. Yon Y, Mikton CR, Gassoumis ZD, Wilber KH. Elder abuse prevalence in community settings: a systematic review and meta-analysis. Lancet Glob Health. 2017;5(2):e147-e156.
8. 8. World Health Organization. Elder abuse [Internet]. Switzerland: World Health Organization; 2020 [cited 2020 Jul 20]. Available from: https://www.who.int/news-room/fact-sheets/detail/elder-abuse

9. 9. Johannesen M, LoGiudice D. Elder abuse: a systematic review of risk factors in community-dwelling elders. Age Ageing. 2013;42(3):292-8.
10. 10. Melchiorre MG, Chiatti C, Lamura G, Torres-Gonzales F, Stankunas M, et al. Social support, socio-economic status, health and abuse among older people in seven European countries. PLoS One. 2013;8(1):e54856.
11. 11. Wu L, Chen H, Hu Y, Xiang H, Yu X, et al. Prevalence and associated factors of elder mistreatment in a rural community in People's Republic of China: a cross-sectional study. PLoS One. 2012;7(3):e33857.
12. 12. Ergin F. Prevalence and risk factors of elder abuse and neglect in a western city of Turkey: a community based study. Bulletin of the Transilvania University of Brasov. 2012;5(54):33-50.
13. 13. Özmete E. The Hwalek-Sengstock Elder Abuse Screening Test: The adaptation study into Turkish. Anatolian Journal of Psychiatry. 2016;17:45-52.
14. 14. Ertan T, Eker E. Reliability, validity, and factor structure of the geriatric depression scale in Turkish elderly: are there different factor structures for different cultures? Int Psychogeriatr. 2000;12(2):163-72.
15. 15. Gungen C, Ertan T, Eker E, Yasar R, Engin F. Reliability and validity of the standardized Mini Mental State Examination in the diagnosis of mild dementia in Turkish population. Turk Psikiyatri Derg. 2002;13(4):273-81.
16. 16. Kucukdeveci AA, Yavuzer G, Tennant A, Suldur N, Sonel B, Arasil T. Adaptation of the modified Barthel Index for use in physical medicine and rehabilitation in Turkey. Scand J Rehabil Med. 2000;32(2):87-92.
17. 17. Isik EI, Yilmaz S, Uysal I, Basar S. Adaptation of the Lawton Instrumental Activities of Daily Living Scale to Turkish: validity and reliability study. Ann Geriatr Med Res. 2020;24(1):35–40.
18. 18. Fadıloğlu Ç, Şenuzun Aykar F. Approach to abuse and neglect in the elderly. Ege Journal of Medicine. 2012;51:69-77.
19. 19. Kissal A, Beser A. Identifying and evaluating elder abuse and neglect. TAF Prev Med Bull. 2009;8(4):357-64.
20. 20. Lök N. Elder abuse and neglect in Turkey: a systematic review. Current Approaches to Psychiatry. 2015;7(2):149-56.
21. 21. Keskinoglu P, Pýcakcýefe M, Bilgic N, Simsek H. Elder abuse and neglect in two different socioeconomic districts in Izmir, Turkey. Int Psychogeriatr. 2007;19:719-31.
22. 22. Goodrich CS. Results of a national survey of state protective services programs: assessing risk and defining victim outcomes. Journal of Elder Abuse & Neglect. 1997;9(1):69-86.
23. 23. Curry SJ, Krist AH, Owens DK, Barry MJ, Caughey AB, et al. Screening for intimate partner violence, elder abuse, and abuse of vulnerable adults: US Preventive Services Task Force final recommendation statement. JAMA. 2018;320(16):1678-87.
24. 24. Dong X, Simon M, Rajan K, Evans DA. Association of cognitive function and risk for elder abuse in a community-dwelling population. Dement Geriatr Cogn Disord. 2011;32(3):209-15.