Exploring the Correlates to Depression in Elder Abuse Victims: Abusive Experience or Individual Characteristics?

Microbiota dysbiosis influences immune system and muscle pathophysiology of dystrophin-deficient mice

Duchenne muscular dystrophy (DMD) is a progressive severe muscle-wasting disease caused by mutations in DMD, encoding dystrophin, that leads to loss of muscle function with cardiac/respiratory failure and premature death. Since dystrophic muscles are sensed by infiltrating inflammatory cells and gut microbial communities can cause immune dysregulation and metabolic syndrome, we sought to investigate whether intestinal bacteria support the muscle immune response in mdx dystrophic murine model. We highlighted a strong correlation between DMD disease features and the relative abundance of Prevotella. Furthermore, the absence of gut microbes through the generation of mdx germ-free animal model, as well as modulation of the microbial community structure by antibiotic treatment, influenced muscle immunity and fibrosis. Intestinal colonization of mdx mice with eubiotic microbiota was sufficient to reduce inflammation and improve muscle pathology and function. This work identifies a potential role for the gut microbiota in the pathogenesis of DMD.

Reliability and validity of the Turkish version of the elder abuse suspicion index in community-dwelling older adults

BACKGROUND

Elder abuse is among the most important ethical issue during the management of older population. The elder abuse suspicion index (EASI) was developed for evaluating abuse in older adults. We aimed to assess the reliability and validity of the Turkish version EASI-Türkiye (TR) among older adults.

METHODS

This study included 89 community-dwelling older adults. The EASI-TR and other scales, including HwalekSengstock Elder Abuse Screening Test-Türkiye (HS/EAST-TR), YGDS, Yesavage Geriatric Depression Scale (YGDS), Instrumental Activities of Daily Living (IADL), and Activities of Daily Living (ADL) were administered to all participants. Internal consistency and external validity were assessed.

RESULTS

EASI-TR revealed an excellent test-retest reliability and acceptable level of internal consistency (Cronbach's α = 0.711). The item-total correlations ranged between 0.296 and 0.701, except for the second item. This test showed significant correlations with the HS/EAST-TR and IADL (p < 0.05), demonstrating good external validity.

DISCUSSION

The EASI-TR appears to have acceptable reliability and validity in screening for abuse in older adults. This tool may recognize cases that require additional evaluation in managing of ethical issues.

Elder Abuse and Depressive Symptoms: Which is Cause and Effect? Bidirectional Longitudinal Studies From the JAGES

Elder abuse is a serious public health concern that increases the risks of negative health outcomes globally. It is well known that abuse in older adults is associated with depression; however, longitudinal studies investigating the causal relationship between these events are scarce. Because the cause precedes the result over time, the temporal relationships between abuse and depression should be verified from each direction. This longitudinal study, therefore, investigated and clarified whether depression causes or results from elder abuse among older Japanese adults. Two longitudinal analyses were conducted using data derived from the Japan Gerontological Evaluation Study. The data were collected in 2010 and 2013 through a mail survey of 1,737 people (983 females, 754 males) across Japan. Of those who did not experience abuse in 2010, 38 (5.0%) males and 53 (5.4%) females newly experienced abuse in 2013. Among respondents who did not have depressive symptoms in 2010, 60 (8.0%) males and 61 (6.2%) females newly reported depressive symptoms in 2013. After adjusting for demographic factors in Analysis 1, people who experienced abuse were 2.28-fold (95% confidence interval [CI] = 1.68-3.09) more likely to have depressive symptoms three years later than those who were not abused. In Analysis 2, respondents who had mild or severe depression in 2010 were 2.23-fold (95% CI = 1.61-3.10) more likely to have experienced abuse after three years than those who did not have depression. After adjusting for several demographic factors, the results showed that abuse can lead to depression and that depression can be a cause of abuse. Therefore, preventing abuse should be considered from both directions.

Linkage of Depression with Elder Abuse among Institutionalized Older Persons in Kathmandu Valley, Nepal

Background

To identify the association between elderly abuse and depression among elderly living in old age homes of Kathmandu Valley, Nepal.

Materials and Methods

A cross-sectional study was carried out in 5 old age homes of Kathmandu Valley, Nepal. The Geriatric Mistreatment Scale and the Geriatric Depression Scale were used to collect information from 220 elderly aged 65 or above, and face-to-face interviews were conducted. Bivariate and multivariate logistic regression analyses were carried out to identify the association between elderly abuse and geriatric depression.

Results

Among the different types of abuse analyzed, the multivariate analysis showed that neglect (AOR = 2.995; CI: 1.249-7.181) and economical abuse (AOR = 4.728, CI: 1.836-12.173) were significantly associated with increased risk of geriatric depression. Furthermore, the study identified that future saving and absence of chronic disease significantly reduced the risk of psychological abuse, neglect, and geriatric depression.

Conclusions

Neglect and economical abuse are a predictor of geriatric depression. Efforts should be directed to increase awareness about the different forms of abuse among the primary caregivers of the elderly. Counseling services and support programs should be introduced in old age homes to address the high burden of geriatric depression.

Polyvictimization and Recurrent Falling in Older Ecuadorian Adults: The Mediation Role of Depressive Symptoms

Objective: To assess depressive symptoms as a mediator in the association between polyvictimization and recurrent falling. Methods: Using data from the Salud, Bienestar y Envejecimiento (Health, Well-being, and Aging) Ecuador Study, we analyzed community-dwelling adults 60 years and older (n = 5227). Recurrent falling was determined as ≥2 falls during the prior 12 months. Polyvictimization was determined as a history of ≥2 types of abuse. The mediator was depressive symptoms. Mediation analyses were based on the VanderWeele method. Results: Polyvictimization was significantly associated with higher odds of recurrent falling, and odds ratio (OR) = 1.45 (95% confidence intervals [CI] 1.20-1.76). Higher depressive symptoms increase the odds for recurrent falling (OR = 1.09 and 95% CI 1.07-1.11). Moreover, depressive symptoms were a significant mediator between polyvictimization and recurrent falling. The mediating effect was 28.4%. Discussion: Polyvictimization was associated with higher odds of recurrent falling, and this association was mediated by depressive symptoms.

Physical and mental health correlates of perceived financial exploitation in older adults: Preliminary findings from the Finance, Cognition, and Health in Elders Study (FINCHES)

Objectives: Financial exploitation (FE) in old age is poorly understood, particularly among those without significant cognitive impairment. The Finance, Cognition, and Health in Elders Study (FINCHES) aims to identify factors associated with FE among cognitively-healthy older adults. Preliminary findings regarding physical and mental health correlates in the pilot phase of FINCHES are reported.Method: Sixteen older adults who self-reported FE were demographically-matched on age, education, sex, and race/ethnicity to eighteen older adults who did not report past FE.Results: Those who believed they were exploited endorsed significantly greater symptoms of depression (p = 0.014) and marginally greater symptoms of anxiety (p = 0.062). Participants trended towards lower perceived successful aging (p = 0.094). Perceived FE participants also endorsed greater medical conditions (p = 0.047), but follow-up individual item analyses suggest that this was driven by problems with sleep (p = 0.030).Conclusions: These preliminary findings from the pilot phase of FINCHES highlight negative mental health factors associated with perceived FE among cognitively-intact older adults.

Older adults' emotional reactions to elder abuse: Individual and victimisation determinants

Elder abuse has been gaining public, state, and scientific attention for the past 40 years, but research focusing on emotional reactions of older adults to victimisation is still scarce. The study describes the emotions and feelings of older adults who experienced abuse in a community setting, and the association between these emotions and individual or abuse characteristics. The cross-sectional study comprises 510 older adults who were identified and referred by four institutions. Participants answered a questionnaire on elder abuse experiences, including the emotion or feeling brought out by the act of abuse that was perceived to be the most serious. Fear and sadness comprised 67.1% of all provided responses. Emotional reactions were associated with functional status, the presence of depressive symptoms, relationship with the perpetrator and, to a limited degree, to the experience of multiple types of abuse. The most significant and meaningful variable was the relationship with the perpetrator. This study demonstrates that older adults present very similar patterns of emotional reactions, but individual characteristics and the established relationship with the perpetrator might mediate the emotional response. Implications for prevention and intervention of elder abuse are discussed.

Tipo mais prevalente de abuso aos idosos e sua correlação com depressão do idoso

Resumo Objetivo: O objetivo deste estudo foi identificar o tipo mais prevalente de abuso aos idosos na Coréia do Sul. Este estudo também analisou que tipo de abuso aos idosos mais afetou a depressão e depois discutiu contramedidas sociais em relação aos tipos prevalentes de abuso aos idosos. Métodos: Trata-se de um estudo descritivo e os dados foram coletados por meio de amostragem por conveniência. Setenta e sete participantes tinham 60 anos ou mais e não tinham deficiência mental ou transtorno depressivo. Cinco tipos diferentes de abuso aos idosos (verbal, emocional, físico, financeiro e negligência) foram medidos, bem como sintomas depressivos. Foi utilizada estatística descritiva para determinar o tipo mais prevalente de abuso aos idosos na Coréia do Sul. Além disso, utilizaram-se testes de correlação bivariada e regressão múltipla para entender a relação entre os tipos de abuso aos idosos e depressão do idoso. Resultados: Entre os cinco tipos de abuso aos idosos, o abuso verbal, emocional e negligência foram mais prevalentes do que os abusos físicos e financeiros. De acordo com a análise bivariada, o abuso emocional e o abuso verbal foram significativamente relacionados à depressão do idoso. Conclusão Os tipos invisíveis de abuso aos idosos, como abuso emocional, verbal e negligência, foram mais prevalentes do que os tipos visíveis, como abuso físico e financeiro. Esses tipos de abuso também foram significativamente correlacionados com a depressão do idoso. Este estudo permite futuros estudos intervencionais para melhorar a percepção dos idosos sobre o abuso e, assim, prevenir o desenvolvimento da depressão dos idosos.