title: Elder self-neglect and abuse and mortality risk in a community-dwelling population.
abstract: BACKGROUND
  Both elder self-neglect and abuse have become increasingly prominent public health issues. The association of either elder self-neglect or abuse with mortality remains unclear.
  
  
  OBJECTIVE
  To examine the relationship of elder self-neglect or abuse reported to social services agencies with all-cause mortality among a community-dwelling elderly population.
  
  
  METHODS
  Prospective, population-based cohort study (conducted from 1993 to 2005) of residents living in a geographically defined community of 3 adjacent neighborhoods in Chicago, Illinois, who were participating in the Chicago Health and Aging Project (CHAP; a longitudinal, population-based, epidemiological study of residents aged > or = 65 years). A subset of these participants had suspected elder self-neglect or abuse reported to social services agencies.
  
  
  METHODS
  Mortality ascertained during follow-up and by use of the National Death Index. Cox proportional hazard models were used to assess independent associations of self-neglect or elder abuse reporting with the risk of all-cause mortality using time-varying covariate analyses.
  
  
  RESULTS
  Of 9318 CHAP participants, 1544 participants were reported for elder self-neglect and 113 participants were reported for elder abuse from 1993 to 2005. All CHAP participants were followed up for a median of 6.9 years (interquartile range, 7.4 years), during which 4306 deaths occurred. In multivariable analyses, reported elder self-neglect was associated with a significantly increased risk of 1-year mortality (hazard ratio [HR], 5.82; 95% confidence interval [CI], 5.20-6.51). Mortality risk was lower but still elevated after 1 year (HR, 1.88; 95% CI, 1.67-2.14). Reported elder abuse also was associated with significantly increased risk of overall mortality (HR, 1.39; 95% CI, 1.07-1.84). Confirmed elder self-neglect or abuse also was associated with mortality. Increased mortality risks associated with either elder self-neglect or abuse were not restricted to those with the lowest levels of cognitive or physical function.
  
  
  CONCLUSIONS
  Both elder self-neglect and abuse reported to social services agencies were associated with increased risk of mortality.
authors: Rush University Medical Center, Chicago, Illinois, USA. xinqidong@gmail.com
authors: XinQi
authors: X
authors: Dong
authors: Melissa
authors: M
authors: Simon
authors: Carlos
authors: C
authors: Mendes de Leon
authors: Terry
authors: T
authors: Fulmer
authors: Todd
authors: T
authors: Beck
authors: Liesi
authors: L
authors: Hebert
authors: Carmel
authors: C
authors: Dyer
authors: Gregory
authors: G
authors: Paveza
authors: Denis
authors: D
authors: Evans
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D002641:Chicago; D003071:Cognition; D004552:Elder Abuse / Q000401:mortality* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D019221:Mandatory Reporting; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012306:Risk; D014505:Urban Population