Adverse Childhood Experiences: Are They Associated With Greater Risk of Elder Abuse Victimization?

Adverse childhood experiences and elder abuse victimization nexus: A systematic review and meta-analysis

Adverse childhood experiences (ACEs) are important life course events that can influence elder abuse victimisation (EAV) among older adults. This systematic review and meta-analysis aimed to provide synthesised and consolidated evidence on the existing associations between ACEs and EAV. A systematic search was conducted across six databases, including PubMed, PsycINFO, CINAHL Complete, Scopus, Google Scholar, and the Web of Science. All studies that addressed associations between ACEs, in singular or multiple form, and EAV were included in the review. Meta-analysis of the extracted odds ratios (ORs) and confidence intervals (CIs) was conducted using the common-effect inverse-variance model. Nine studies (cross-sectional design = 7; cohort design = 2) met the inclusion criteria. Included studies examined multiple ACEs and multiple EAVs associations (N = 3); at least single ACE and multiple EAVs (N = 3); any single form of ACE and multiple EAVs (N = 3); multiple ACEs-any single form of EAV nexus (N = 2); multiple ACEs-financial elder abuse association (N = 2); and multiple ACEs-physical elder abuse nexus (N = 2). Pooled ORs and CIs showed statistically significant results for all ACEs and EAVs associations whether in singular or multiple form. The results indicate that interventions designed to reduce ACEs, in singular or multiple form, early in life targeting residential and community-dwelling older adults may be relevant in reducing the incidence of EAV. The life course perspective s be integrated into the planning for support services for children, families, and older adults to prevent EAV in singular or multiple forms in later life.

Trauma Theory and Abuse, Neglect and Violence Across the Life Course

A literature review of recent prevalence and prospective studies on interpersonal violence (IPV) identifies a link among child abuse, intimate partner violence, and elder abuse that had not emerged from life-stage-specific studies on abuse, neglect, and violence against older persons. In line with a developmental understanding of IPV from a life course perspective, early life trauma is emerging as an explanatory theory of IPV across the life course. This paradigm shift in the field of elder abuse challenges more traditional explanations of IPV in old age, such as ageism, but opens up new opportunities for interventions leading to prevention and treatment of abuse, neglect, and violence against older adults. Prevalence studies that include older subjects and questions about violence experienced as children and younger adults consistently identify child abuse as a risk factor for IPV experienced in old age. Similarly, prospective studies on IPV that follow subjects from childhood to old age identify lifetime patterns of abuse. Qualitative studies of IPV in old age that include retrospective data suggest a link as well. IPV perpetrated against children and adults of all ages by persons in positions of trust can lead to trauma that has adverse lifelong behavioral and relational implications. This provides a link between trauma theory and violence against older people. Until recently, abuse, neglect, and violence were conceptualized differently based on the life stage of the victim. While historically the definitions for partner and non-partner violence diverged based on the life stage of victims, more recently this has begun to converge. Understanding violence from a life course and trauma-informed perspective better identifies risk factors and interventions for IPV against older adults. Intersectionality of age and gender variables demonstrate differences and similarities among populations studied.

Elder abuse experienced by older Mexican women with disabilities: a current and retrospective view on domestic violence

The objectives of this study were: 1) to estimate the prevalence of child abuse (CA), intimate partner violence (IPV), and elder abuse (EA) in a representative sample of older Mexican women by status, type, and cause of disability; and 2) to examine the associations of EA with CA, IPV, and disability status. We conducted a secondary data analysis of 21,718 women aged 60 years and older. Older women with disabilities had higher prevalences of CA, IPV, and EA than those with some difficulties or without disabilities. In older women whose disability was acquired at birth or due to aggression, this prevalence was especially high. Older women with disabilities and a history of CA and IPV were twice as likely to suffer EA. Policymakers and government leaders should incorporate the matter of violence against women with disabilities into their public agendas. This should be done while considering the women's various disabilities and causes of disability.

Elder abuse prevalence and risk factors: findings from the Canadian Longitudinal Study on Aging

Elder abuse (EA) is a pervasive problem with serious consequences. Previous population-based EA risk factor research has largely used cross-sectional designs that limit causal inferences, or agency records to identify victims, which threatens external validity. Based on a national, prospective, population-based cohort sample of older adults (n = 23,468) over a 3-year period from the Canadian Longitudinal Study on Aging, the current study sought to estimate the prevalence of EA and identify risk and protective factors. Past-year prevalence of any EA was 10.0%. Older adults with greater vulnerability related to physical, cognitive and mental health, childhood maltreatment and shared living were at higher EA risk, while social support was protective against EA. Older adults identifying as Black or reporting financial need were at heightened EA risk. This longitudinal, population-based study advances our understanding of EA risk/protective factors across several domains and informs the development of EA prevention strategies.

Mechanisms connecting insomnia to hopelessness among Chinese older adults: Serial mediating roles of fatigue and social support

BACKGROUND

Hopelessness and insomnia remain growing mental health issues worldwide, their relationship has been neglected by international development policies, especially in the countries with rapidly aging population like China. However, there is little conclusive evidence on the mechanisms through which insomnia severity influences hopelessness. Based on previous research regarding the significant associations among fatigue, social support, insomnia and hopelessness, this study aims to investigate the relationship between insomnia and hopelessness as well as how insomnia affects hopelessness through fatigue and social support.

METHODS

A population-based data including 946 community-dwelling older adults extracted from "Elderly Care Household Survey in 2019" in Beijing were used. The age of the participants ranged from 66 to 97 years old, and 53.3% of the respondents were female. Intercorrelations among insomnia, fatigue, social support and hopelessness were examined. Serial multiple mediation models were analyzed by the bootstrapping method to assess whether fatigue and social support serially mediate the relationship between insomnia and hopelessness.

RESULTS

Higher level of insomnia severity (coefficient = 0.0421, p < 0.001), higher level of fatigue (coefficient = 0.0171, p < 0.001), and lower level of social support (coefficient = -0.0320, p < 0.001) were significantly associated with higher level of hopelessness. Fatigue and social support in serial, mediated the relationship between insomnia and hopelessness (total effect: coefficient = 0.0623, 95% CI [0.0466, 0.0780]; total direct effect: coefficient = 0.0421, 95% CI [0.0262, 0.0581]; total indirect effect: coefficient = 0.0202, 95% CI [0.0147, 0.0272]).

CONCLUSIONS

Improving sleep quality and eliminating fatigue could effectively alleviate the sense of hopelessness among Chinese older adults. In addition, establishing stronger social support brought by social network from family and friends could confer resilience against the negative effects of despair brought by insomnia. Our findings highlighted the mechanism connecting insomnia to hopelessness, which would inspire the future practice.