Association Between Frailty and Elder Abuse in Community-Dwelling Older Adults in Mexico City

Abstract

Objectives: To investigate the association between frailty and elder abuse in community-dwelling older adults.

Design: Secondary cross-sectional analysis of a prospective cohort.

Setting: The Frailty, Dynapenia and Sarcopenia in Mexican Adults study, a cohort of community-dwelling adults from 2 municipalities in Mexico City.

Participants: Community-dwelling adults aged 60 and older (N=487, mean age 73.2 ± 8.0, 80% female).

Measurements: Elder abuse was assessed using the Geriatric Mistreatment Scale and frailty using the Frailty Phenotype. Abuse was then classified as total abuse (any subtype), conflict abuse (physical, psychological, sexual abuse), financial abuse, and caregiver neglect. Information was also obtained on sociodemographic characteristics, comorbidities, mental status, nutritional status, disability, and polypharmacy.

Results: Prevalence of total abuse was 35.7%. Frailty was associated with total abuse (odds ratio (OR)=2.52, 95% confidence interval (CI)=1.22-5.21, p=.01) and conflict abuse (OR=2.50, 95% CI=1.18-5.33, p=.02) after adjusting for confounders but not with financial abuse or caregiver neglect. Depression was an effect modifier in the association between frailty and total abuse. Frailty was associated with total abuse in participants with depression (OR=5.23, 95% CI=1.87-14.56, p=.002) but not in those without (OR=0.55, 95% CI=0.10-2.87, p=.47).

Conclusion: Frailty is associated with total and conflict abuse in community-dwelling older adults. Further studies are needed to elucidate the effect of frailty on elder abuse and investigate the effectiveness of interventions for primary and secondary prevention.

Keywords: elder abuse; frailty; mistreatment; vulnerability.