title: Elder mistreatment in a community dwelling population: the Malaysian Elder Mistreatment Project (MAESTRO) cohort study protocol.
abstract: Despite being now recognised as a global health concern, there is still an inadequate amount of research into elder mistreatment, especially in low and middle-income regions. The purpose of this paper is to report on the design and methodology of a population-based cohort study on elder mistreatment among the older Malaysian population. The study aims at gathering data and evidence to estimate the prevalence and incidence of elder mistreatment, identify its individual, familial and social determinants, and quantify its health consequences.
  
  
  
  This is a community-based prospective cohort study using randomly selected households from the national census. A multistage sampling method was employed to obtain a total of 2496 older adults living in the rural Kuala Pilah district. The study is divided into two phases: cross-sectional study (baseline), and a longitudinal follow-up study at the third and fifth years. Elder mistreatment was measured using instrument derived from the previous literature and modified Conflict Tactic Scales. Outcomes of elder mistreatment include mortality, physical function, mental health, quality of life and health utilisation. Logistic regression models are used to examine the relationship between risk factors and abuse estimates. Cox proportional hazard regression will be used to estimate risk of mortality associated with abuse. Associated annual rate of hospitalisation and health visit frequency, and reporting of abuse, will be estimated using Poisson regression.
  
  
  
  The study has been approved by the Medical Ethics Committee of the University of Malaya Medical Center (MEC Ref 902.2) and the Malaysian National Medical Research Register (NMRR-12-1444-11726). Written consent was obtained from all respondents prior to baseline assessment and subsequent follow-up. Findings will be disseminated to local stakeholders via forums with community leaders, and health and social welfare departments, and published in appropriate scientific journals and presented at conferences.
authors.affiliation: Department of Social and Preventive Medicine, Faculty of Medicine, Julius Centre University of Malaya, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Wan Yuen
authors.initials: WY
authors.lastname: Choo
authors.affiliation: Department of Social and Preventive Medicine, Faculty of Medicine, Julius Centre University of Malaya, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Noran Naqiah
authors.initials: NN
authors.lastname: Hairi
authors.affiliation: Department of Social and Preventive Medicine, Faculty of Medicine, Julius Centre University of Malaya, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Rajini
authors.initials: R
authors.lastname: Sooryanarayana
authors.affiliation: Department of Social and Preventive Medicine, Faculty of Medicine, Julius Centre University of Malaya, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Raudah Mohd
authors.initials: RM
authors.lastname: Yunus
authors.affiliation: Department of Social and Preventive Medicine, Faculty of Medicine, Julius Centre University of Malaya, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Farizah Mohd
authors.initials: FM
authors.lastname: Hairi
authors.affiliation: Department of Social and Preventive Medicine, Faculty of Medicine, Julius Centre University of Malaya, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Norliana
authors.initials: N
authors.lastname: Ismail
authors.affiliation: Department of Social and Preventive Medicine, Faculty of Medicine, Julius Centre University of Malaya, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Shathanapriya
authors.initials: S
authors.lastname: Kandiben
authors.affiliation: Negeri Sembilan State Health Department, Kuala Lumpur, Malaysia.
authors.forename: Zainudin
authors.initials: Z
authors.lastname: Mohd Ali
authors.affiliation: Negeri Sembilan State Health Department, Kuala Lumpur, Malaysia.
authors.forename: Sharifah Nor
authors.initials: SN
authors.lastname: Ahmad
authors.affiliation: Negeri Sembilan State Health Department, Kuala Lumpur, Malaysia.
authors.forename: Inayah
authors.initials: I
authors.lastname: Abdul Razak
authors.affiliation: Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Sajaratulnisah
authors.initials: S
authors.lastname: Othman
authors.affiliation: Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Maw Pin
authors.initials: MP
authors.lastname: Tan
authors.affiliation: Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Fadzilah Hanum Mohd
authors.initials: FH
authors.lastname: Mydin
authors.affiliation: Department of Social and Preventive Medicine, Faculty of Medicine, Julius Centre University of Malaya, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Devi
authors.initials: D
authors.lastname: Peramalah
authors.affiliation: Fordham University, New York, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Brownell
authors.affiliation: Department of Social and Preventive Medicine, Faculty of Medicine, Julius Centre University of Malaya, University of Malaya, Kuala Lumpur, Malaysia.
authors.forename: Awang
authors.initials: A
authors.lastname: Bulgiba
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D004552:Elder Abuse / Q000401:mortality / Q000523:psychology / Q000706:statistics & numerical data*; D015340:Epidemiologic Research Design; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D015994:Incidence; D057187:Independent Living; D008137:Longitudinal Studies; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors
keywords: cohort; elder abuse; elder mistreatment; elder neglect; longitudinal study