Elder abuse as a risk factor for hospitalization in older persons

Purpose: This study aims to examine the relationship between overall elder abuse and specific subtypes of elder abuse and rate of hospitalization in a community-dwelling population of older adults. Methods: A prospective population-based study is conducted in community-dwelling older adults who participated in Chicago Health and Aging Project. Of the 6,674 participants in the Chicago Health and Aging Project, 106 participants were reported to social services agency for elder abuse. The primary predictor was elder abuse (reported and confirmed) reported to social services agency. The outcome of interest was the annual rate of hospitalization obtained from the Center for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships. Results: The unadjusted average annual rate of hospitalization for those without elder abuse was 0.62 (95% CI, 0.59-0.66) and for those with reported elder abuse was 1.97 (95% CI, 1.33-2.61). After adjusting for sociodemographic, socioeconomic variables, medical commorbidities, cognitive and physical function, and psychosocial wellbeing, reported elder abuse had higher rates of hospitalization (RR, 2.00 (1.45-2.75)). Psychological abuse (RR, 2.22 (1.44-3.43)), financial exploitation (RR, 1.75 (1.06-2.90)), caregiver neglect (RR, 2.43 (1.60-3.69)) and two or more types of elder abuse (RR, 2.59 (1.82-3.66)) were associated with increased rates of hospitalization, after considering the same potential confounders. Interaction term analyses suggested that the association between elder abuse and hospitalization did not differ across the levels of medical commorbidities, cognitive and functional impairment, or psychosocial distress. Conclusion: Elder abuse was associated with increased rates of hospitalization in this community population.