Analysis also indicated that reported elder abuse was significantly associated with increased risk of overall mortality (about 40 percent). Confirmed elder abuse was associated with about a two times higher risk of death.
Increased mortality risks associated with either elder self-neglect or abuse were not restricted to those with the lowest levels of cognitive or physical function.
“... this study is the first, to our knowledge, to demonstrate increased mortality risk for reported and confirmed elder self-neglect across different levels of cognitive and physical function, challenging a belief that self-neglect and the potential for adverse health outcomes are confined to those with the most impaired cognitive and physical function. Rather, our findings suggest that even among those individuals with milder levels of cognitive and physical functional impairment, elder self-neglect is associated with substantially increased risk of death.”
“These results may be useful not only in informing future research efforts into elder self-neglect and abuse, but also to inform relevant clinical, social, and policy guidelines developed to treat and prevent elder self-neglect and abuse on a national level,” the researchers conclude.
Thomas M. Gill, MD, of Yale University School of Medicine, New Haven, Conn., writes in an accompanying editorial, Elder Self-neglect - Medical Emergency or Marker of Extreme Vulnerability?” that elder self-neglect poses significant challenges to the health care system and social service agencies.
“The number of cases of reported self-neglect has been increasing and will likely continue to increase with the graying of the baby boom generation,” Dr. Gill writes. “Assuming that the mortality related to elder self-neglect and abuse is causal, it could be interpreted as a failure of society and the health care system to adequately protect the most vulnerable older adults. To better address the complex needs of this burgeoning population, a stronger work force well prepared to care for older adults will be needed, as highlighted in a recent Institute of Medicine report. While awaiting evidence-based answers to the myriad unanswered questions regarding the epidemiology and management of elder self-neglect and abuse, health care professionals caring for older adults should act to renew the social contract with older individuals in the United States by supporting and expanding model programs for these potentially devastating disorders.”
References: JAMA. 2009;302[5]:517-526 and JAMA. 2009;302[5]:570-571.
