2nd International Nursing Conference
November 1-3, 2017 Barcelona, Spain
Mental Health Outcomes: 8 Year Follow-Up of the National Elder Mistreatment Study
1Medical University of South Carolina, USA
2VAMC Charleston, USA
3Universitat Autònoma de Barcelona, Spain
Background: The National Elder Mistreatment Study (NEMS), conducted in 2008 with 5,777 community residing older adults, represented the largest epidemiological study of elder abuse conducted in this country. The original study assessed psychological, physical, sexual, and neglectful mistreatment using behaviorally-specific queries and documented unexpectedly high rates of abuse (i.e., approximately 10%). However, mental health correlates of abuse were understudied. The purpose of this study was to explore the current mental health status of those elderly people who identified themselves as victims of elder abuse through NEMS 2008.
Methods: We attempted to re-contact the entire original sample of elder abuse victims (now age 68 and over) and a reference sample of non-victims at about a 1:3 ratio, producing a follow-up sample of 172 abuse victims (of the original 684) and a reference sample of 602 non-victims. Computer assisted telephone survey methodology was used to standardize data collection while measuring new episodes of abuse since the last survey, and to determine presence of DSM-V diagnoses of major depression (MD), post-traumatic stress disorder (PTSD), and generalized anxiety disorder (GAD).
Results: Reports of past-year abuse in 2008 strongly predicted current MD, PTSD, and GAD. Specifically, odds ratios (OR) for MD (16.7% victims vs. 5.8% non-victims; OR: 3.3, CI: 1.7-6.3), PTSD (13.1% vs. 1.6%; OR: 9.3, CI: 3.9-22.1), and GAD (10.7% vs. 2.0%; OR: 5.8, CI: 2.4-13.8) demonstrate dramatically increased risk of these disorders in the abused group. Of even greater interest and potential import was the finding that high social support in 2008 was extremely protective against psychopathology at follow-up 8 years later, such that rates of MD, PTSD, and GAD in the abused group with high social support mirrored those in the non-abused group.
Conclusion: Elder abuse is a prevalent problem in the US, and the present study demonstrates that its outcomes are lasting and negative. However, perceived social support appears to be highly protective against the negative effects of abuse, and interventions to enhance social connectedness of older adults may prevent depression and anxiety disorders in elder abuse victims.
Ron Acierno is a Professor and Associate Dean for Research in the College of Nursing and a Senior Clinical Research Scientist at the Ralph H. Johnson Veterans Affairs Medical Center, MUSCʼs Consortium VA partner. Finally, he is the Clinical Training Director and Board Member of the nonprofit Veterans on Deck, an organization he founded that uses sailing to impart socialization, teambuilding and personal growth in veterans recovering from PTSD, substance use, and who have been victims of Military Sexual Trauma.