title: Prospective study of the elder self-neglect and ED use in a community population.
abstract: OBJECTIVE
  This study aims to quantify the relation between elder self-neglect and rate of emergency department utilization in a community-dwelling population.
  
  
  METHODS
  A prospective population-based study is conducted in a geographically defined community in Chicago of community-dwelling older adults who participated in the Chicago Health and Aging Project. Of the 6864 participants in the Chicago Health and Aging Project, 1165 participants were reported to social services agency for suspected elder self-neglect. The primary predictor was elder self-neglect reported to social services agency. The outcome of interest was the annual rate of emergency department utilization obtained from the Center for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships.
  
  
  RESULTS
  The average annual rate of emergency department visits for those without elder self-neglect was 0.6 (1.3), and for those with reported elder self-neglect, it was 1.9 (3.4). After adjusting for sociodemographics, socioeconomic variables, medical conditions, and cognitive and physical function, older people who self-neglect had significantly higher rates of emergency department utilization (rate ratio, 1.42; 95% confidence interval, 1.29-1.58). Greater self-neglect severity (mild: standardized parameter estimate [PE], 0.27; standard error [SE], 0.04; P < .001; moderate: PE, 0.41; SE, 0.03; P < .001; severe: PE, 0.55; SE, 0.09; P < .001) was associated with increased rates of emergency department utilization, after considering the same confounders.
  
  
  CONCLUSIONS
  Elder self-neglect was associated with increased rates of emergency department utilization in this community population. Greater self-neglect severity was associated with a greater increase in the rate of emergency department utilization.
authors.affiliation: Rush University Medical Center, Chicago, IL 60612, USA. xinqi_dong@rush.edu
authors.forename: Xinqi
authors.initials: X
authors.lastname: Dong
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Simon
authors.forename: Denis
authors.initials: D
authors.lastname: Evans
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D002641:Chicago / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012737:Sex Factors