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Vol. 54, No. 6, 2008
Issue release date: November 2008
Free Access
Gerontology 2008;54:381–388
(DOI:10.1159/000143228)

Is Greater Social Support a Protective Factor against Elder Mistreatment?

Dong X.a · Simon M.A.b
aDepartment of Internal Medicine, Rush University Medical Center, and bDepartment of Obstetrics/Gynecology, Northwestern Medical Center, Chicago, Ill., USA
email Corresponding Author

Abstract

Background: Elder mistreatment (EM) is a pervasive global health issue and a violation of basic human rights. Our prior study indicates that EM is alarmingly common in an urban Chinese population, yet little is known about risk and/or protective factors for EM. Objective: This study’s goal was to examine the association of social support with the risk of EM and underlying hypothesis is that greater social support is associated with a lower risk for EM. Methods: A cross-sectional descriptive study was performed in a major urban medical center in Nanjing, China. A total of 412 subjects aged 60 years or older who presented to the general medical clinic were surveyed. Social support was assessed using validated instruments Social Support Index (SSI); direct questions were asked about their mistreatment since age 60 using the modified Vulnerability to Abuse Screening Scale (VASS). Results: EM was found in 35% of the participants. After adjusting for potential confounding factors, several factors were associated with a lower risk of mistreatment: having someone to listen to and talk to (OR = 0.18, 95% CI, 0.08–0.39), having someone to get you good advice from (OR = 0.15 (0.07–0.34)), having someone to show love and affection to (OR = 0.30 (0.12–0.75)), having someone available who can help with daily chores (OR = 0.43 (0.22–0.85)), having contact with someone they can trust and confide in (OR = 0.08 (0.03–0.23)), and having someone they can count on for emotional support (OR = 0.11 (0.04–0.28)). Regarding total social support scores (range 1–32), every point higher in social support was associated with a 6% lower risk for EM (OR = 0.94 (0.91–0.97)). Greater social support was associated with a 59% lower risk for EM (OR = 0.41 (0.19–0.90)). Conclusion: Greater social support may be a protective factor against EM in this population. Prospective studies are needed to confirm this finding. Interventions that improve social support may prevent EM.


 goto top of outline Key Words

  • Elder mistreatment
  • Social support
  • Chinese population

 goto top of outline Abstract

Background: Elder mistreatment (EM) is a pervasive global health issue and a violation of basic human rights. Our prior study indicates that EM is alarmingly common in an urban Chinese population, yet little is known about risk and/or protective factors for EM. Objective: This study’s goal was to examine the association of social support with the risk of EM and underlying hypothesis is that greater social support is associated with a lower risk for EM. Methods: A cross-sectional descriptive study was performed in a major urban medical center in Nanjing, China. A total of 412 subjects aged 60 years or older who presented to the general medical clinic were surveyed. Social support was assessed using validated instruments Social Support Index (SSI); direct questions were asked about their mistreatment since age 60 using the modified Vulnerability to Abuse Screening Scale (VASS). Results: EM was found in 35% of the participants. After adjusting for potential confounding factors, several factors were associated with a lower risk of mistreatment: having someone to listen to and talk to (OR = 0.18, 95% CI, 0.08–0.39), having someone to get you good advice from (OR = 0.15 (0.07–0.34)), having someone to show love and affection to (OR = 0.30 (0.12–0.75)), having someone available who can help with daily chores (OR = 0.43 (0.22–0.85)), having contact with someone they can trust and confide in (OR = 0.08 (0.03–0.23)), and having someone they can count on for emotional support (OR = 0.11 (0.04–0.28)). Regarding total social support scores (range 1–32), every point higher in social support was associated with a 6% lower risk for EM (OR = 0.94 (0.91–0.97)). Greater social support was associated with a 59% lower risk for EM (OR = 0.41 (0.19–0.90)). Conclusion: Greater social support may be a protective factor against EM in this population. Prospective studies are needed to confirm this finding. Interventions that improve social support may prevent EM.

Copyright © 2008 S. Karger AG, Basel


 goto top of outline References
  1. Tatara T: Summaries of National Elder Abuse Data: An Exploratory Study of State Statistics. Washington, National Aging Resource Center on Elder Abuse, 1990.
  2. Teaster PB, Dugar T, Mendiondo M, Abner EL, Cecil KA, Otto JM: The 2004 Survey of Adult Protective Services: Abuse of Adults 60 Years of Age and Older. www.elderabusecenter.org/pdf/research/apsreport030703.pdf. Accessed April 4, 2007.
  3. Lachs MS, Williams CS, O’Brien S, Pillemer KA, Charlson ME: The mortality of elder mistreatment. JAMA 1998;280:428–432.
  4. Dong X: Medical implications of elder abuse and neglect. Clin Geriatr Med 2005;21:293–313.
  5. National Research Council: Elder Mistreatment: Abuse, Neglect and Exploitation in an Aging America. Washington, National Academies Press, 2003.
  6. Dong X, Simon MA, Gorbien M: Elder abuse and neglect in an urban Chinese population. J Elder Abuse Negl 2007;19:79–96.
  7. Sarason I, Levine H, Basham R, Sarason B: Assessing social support: the Social Support Questionnaire. J Pers Soc Psychol 1983;44:127–139.

    External Resources

  8. Penninx BW, van Tilburg T, Kriegsman DM, Deeg DJ, Boeke AJ, van Eijk JT: Effects of social support and personal coping resources on mortality in older age: the Longitudinal Aging Study Amsterdam. Am J Epidemiol 1997;146:510–519.
  9. Wilkins K: Social support and mortality in seniors. Health Rep 2003;14:21–34.

    External Resources

  10. Temkin-Greener H, Bajorska A, Peterson DR, et al: Social support and risk-adjusted mortality in a frail older population. Med Care 2004;42:779–788.
  11. Rowe JL, Conwell Y, Schulberg HC, Bruce ML: Social support and suicidal ideation in older adults using home healthcare services. Am J Geriatr Psychiatry 2006;14:758–766.
  12. Fulmer T, Paveza G, VandeWeerd C, et al: Dyadic vulnerability and risk profiling for elder neglect. Gerontologist 2005;45:525–534.
  13. Shugarman LR, Fries BE, Wolf RS, Morris JN: Identifying older people at risk of abuse during routine screening practices. J Am Geriatr Soc 2003;51:24–31.
  14. Lee M, Kolomer SR: Caregiver burden, dementia, and elder abuse in South Korea. J Elder Abuse Negl 2005;17:61–74.
  15. Chokkanathan S, Lee AE: Elder mistreatment in urban India: a community-based study. J Elder Abuse Negl 2005;17:45–61.
  16. Woo J, Kwok T, Sze FKH, Yuan HJ: Ageing in China: health and social consequences and responses. Int J Epidemiol 2002;31:772–775.
  17. Banister J: Implications of the ageing of China’s population. Changing family structure and population aging in China: a comparative approach. Beijing, Peking University Press, 1990.
  18. Tam S, Neysmith S: Disrespect and isolation: elder abuse in Chinese communities. Can J Aging 2006;25:141–151.
  19. Schofield MJ, Mishra GD: Validity of self-report screening scale for elder abuse: Women’s Health Australia Study. Gerontologist 2003;43:110–120.
  20. Hwalek MA, Sengstock MC: Assessing the probability of abuse in the elderly: toward development of a clinical screening instrument. J Appl Gerontol 1986;5:153–173.
  21. Williams RB, Barefoot JC, Califf RM, et al: Prognostic importance of social and economic resources among medically treated patients with angiographically documented coronary artery disease. JAMA 1992;267:520–524.
  22. Berkman LF, Leo-Summers L, Horwitz RI: Emotional support and survival after myocardial infarction. A prospective, population-based study of the elderly. Ann Intern Med 1992;117:1003–1009.
  23. Gorkin L, Schron EB, Brooks MM, et al: Psychosocial predictors of mortality in the Cardiac Arrhythmia Suppression Trial-1 (CAST-1). Am J Cardiol 1993;71:263–267.
  24. Beck A, Steer R, Garbin M: Psychometric properties of the depression inventory: 25 years of evaluation. Clin Psychol Rev 1981;8:1003–1009.
  25. Blumenthal JA, Burg MM, Barefoot J, Williams RB, Haney T, Zimet G: Social support, type A behavior, and coronary artery disease. Psychosom Med 1987;49:331–340.
  26. ENRICHD Investigators: Enhancing recovery in coronary heart disease patients. Study design and methods. Am Heart J 2000;139:1–9.

    External Resources

  27. Vaglio J Jr, Conard M, Poston WS, et al: Testing the performance of the ENRICHD social support instrument in cardiac patients. Health Qual Life Outcomes 2004;2:24.
  28. Berwick DM, Murphy JM, Goldman PA, Ware JE Jr, Barsky AJ, Weinstein MC: Performance of a five-item mental health screening test. Med Care 1991;29:169–176.
  29. McHorney CA, Ware JE Jr, Raczek AE: The MOS 36-Item Short-Form Health Survey (SF-36). II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 1993;31:247–263.
  30. SAS Online Doc, Version 9.1.3. Cary, SAS Institute Inc, 2004.
  31. Comijs HC, Penninx BW, Knipscheer KP, van Tilburg W: Psychological distress in victims of elder mistreatment: the effects of social support and coping. J Gerontol B Psychol Sci Soc Sci 1999;54:240–245.

    External Resources

  32. Litty CG, Kowalski R, Minor S: Moderating effects of physical abuse and perceived social support on the potential to abuse. Child Abuse Negl 1996;20:305–314.
  33. Fagan J: Contributions of family violence research to criminal justice policy on wife assault: paradigms of science and social control. Violence Vict 1988;3:159–186.

 goto top of outline Author Contacts

XinQi Dong, MD
Section of Geriatric Medicine, Department of Internal Medicine
Rush University Medical Center
Chicago, IL 60612 (USA)
Tel. +1 312 942 6087, Fax +1 312 563 4212, E-Mail xinqi_dong@rush.edu


 goto top of outline Article Information

Received: December 21, 2007
Accepted: April 22, 2008
Published online: July 7, 2008
Number of Print Pages : 8
Number of Figures : 2, Number of Tables : 2, Number of References : 33


 goto top of outline Publication Details

Gerontology (International Journal of Experimental, Clinical, Behavioural and Technological Gerontology)

Vol. 54, No. 6, Year 2008 (Cover Date: November 2008)

Journal Editor: Wick G. (Innsbruck)
ISSN: 0304–324X (Print), eISSN: 1423–0003 (Online)

For additional information: http://www.karger.com/GER


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Abstract

Background: Elder mistreatment (EM) is a pervasive global health issue and a violation of basic human rights. Our prior study indicates that EM is alarmingly common in an urban Chinese population, yet little is known about risk and/or protective factors for EM. Objective: This study’s goal was to examine the association of social support with the risk of EM and underlying hypothesis is that greater social support is associated with a lower risk for EM. Methods: A cross-sectional descriptive study was performed in a major urban medical center in Nanjing, China. A total of 412 subjects aged 60 years or older who presented to the general medical clinic were surveyed. Social support was assessed using validated instruments Social Support Index (SSI); direct questions were asked about their mistreatment since age 60 using the modified Vulnerability to Abuse Screening Scale (VASS). Results: EM was found in 35% of the participants. After adjusting for potential confounding factors, several factors were associated with a lower risk of mistreatment: having someone to listen to and talk to (OR = 0.18, 95% CI, 0.08–0.39), having someone to get you good advice from (OR = 0.15 (0.07–0.34)), having someone to show love and affection to (OR = 0.30 (0.12–0.75)), having someone available who can help with daily chores (OR = 0.43 (0.22–0.85)), having contact with someone they can trust and confide in (OR = 0.08 (0.03–0.23)), and having someone they can count on for emotional support (OR = 0.11 (0.04–0.28)). Regarding total social support scores (range 1–32), every point higher in social support was associated with a 6% lower risk for EM (OR = 0.94 (0.91–0.97)). Greater social support was associated with a 59% lower risk for EM (OR = 0.41 (0.19–0.90)). Conclusion: Greater social support may be a protective factor against EM in this population. Prospective studies are needed to confirm this finding. Interventions that improve social support may prevent EM.



 goto top of outline Author Contacts

XinQi Dong, MD
Section of Geriatric Medicine, Department of Internal Medicine
Rush University Medical Center
Chicago, IL 60612 (USA)
Tel. +1 312 942 6087, Fax +1 312 563 4212, E-Mail xinqi_dong@rush.edu


 goto top of outline Article Information

Received: December 21, 2007
Accepted: April 22, 2008
Published online: July 7, 2008
Number of Print Pages : 8
Number of Figures : 2, Number of Tables : 2, Number of References : 33


 goto top of outline Publication Details

Gerontology (International Journal of Experimental, Clinical, Behavioural and Technological Gerontology)

Vol. 54, No. 6, Year 2008 (Cover Date: November 2008)

Journal Editor: Wick G. (Innsbruck)
ISSN: 0304–324X (Print), eISSN: 1423–0003 (Online)

For additional information: http://www.karger.com/GER


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

References

  1. Tatara T: Summaries of National Elder Abuse Data: An Exploratory Study of State Statistics. Washington, National Aging Resource Center on Elder Abuse, 1990.
  2. Teaster PB, Dugar T, Mendiondo M, Abner EL, Cecil KA, Otto JM: The 2004 Survey of Adult Protective Services: Abuse of Adults 60 Years of Age and Older. www.elderabusecenter.org/pdf/research/apsreport030703.pdf. Accessed April 4, 2007.
  3. Lachs MS, Williams CS, O’Brien S, Pillemer KA, Charlson ME: The mortality of elder mistreatment. JAMA 1998;280:428–432.
  4. Dong X: Medical implications of elder abuse and neglect. Clin Geriatr Med 2005;21:293–313.
  5. National Research Council: Elder Mistreatment: Abuse, Neglect and Exploitation in an Aging America. Washington, National Academies Press, 2003.
  6. Dong X, Simon MA, Gorbien M: Elder abuse and neglect in an urban Chinese population. J Elder Abuse Negl 2007;19:79–96.
  7. Sarason I, Levine H, Basham R, Sarason B: Assessing social support: the Social Support Questionnaire. J Pers Soc Psychol 1983;44:127–139.

    External Resources

  8. Penninx BW, van Tilburg T, Kriegsman DM, Deeg DJ, Boeke AJ, van Eijk JT: Effects of social support and personal coping resources on mortality in older age: the Longitudinal Aging Study Amsterdam. Am J Epidemiol 1997;146:510–519.
  9. Wilkins K: Social support and mortality in seniors. Health Rep 2003;14:21–34.

    External Resources

  10. Temkin-Greener H, Bajorska A, Peterson DR, et al: Social support and risk-adjusted mortality in a frail older population. Med Care 2004;42:779–788.
  11. Rowe JL, Conwell Y, Schulberg HC, Bruce ML: Social support and suicidal ideation in older adults using home healthcare services. Am J Geriatr Psychiatry 2006;14:758–766.
  12. Fulmer T, Paveza G, VandeWeerd C, et al: Dyadic vulnerability and risk profiling for elder neglect. Gerontologist 2005;45:525–534.
  13. Shugarman LR, Fries BE, Wolf RS, Morris JN: Identifying older people at risk of abuse during routine screening practices. J Am Geriatr Soc 2003;51:24–31.
  14. Lee M, Kolomer SR: Caregiver burden, dementia, and elder abuse in South Korea. J Elder Abuse Negl 2005;17:61–74.
  15. Chokkanathan S, Lee AE: Elder mistreatment in urban India: a community-based study. J Elder Abuse Negl 2005;17:45–61.
  16. Woo J, Kwok T, Sze FKH, Yuan HJ: Ageing in China: health and social consequences and responses. Int J Epidemiol 2002;31:772–775.
  17. Banister J: Implications of the ageing of China’s population. Changing family structure and population aging in China: a comparative approach. Beijing, Peking University Press, 1990.
  18. Tam S, Neysmith S: Disrespect and isolation: elder abuse in Chinese communities. Can J Aging 2006;25:141–151.
  19. Schofield MJ, Mishra GD: Validity of self-report screening scale for elder abuse: Women’s Health Australia Study. Gerontologist 2003;43:110–120.
  20. Hwalek MA, Sengstock MC: Assessing the probability of abuse in the elderly: toward development of a clinical screening instrument. J Appl Gerontol 1986;5:153–173.
  21. Williams RB, Barefoot JC, Califf RM, et al: Prognostic importance of social and economic resources among medically treated patients with angiographically documented coronary artery disease. JAMA 1992;267:520–524.
  22. Berkman LF, Leo-Summers L, Horwitz RI: Emotional support and survival after myocardial infarction. A prospective, population-based study of the elderly. Ann Intern Med 1992;117:1003–1009.
  23. Gorkin L, Schron EB, Brooks MM, et al: Psychosocial predictors of mortality in the Cardiac Arrhythmia Suppression Trial-1 (CAST-1). Am J Cardiol 1993;71:263–267.
  24. Beck A, Steer R, Garbin M: Psychometric properties of the depression inventory: 25 years of evaluation. Clin Psychol Rev 1981;8:1003–1009.
  25. Blumenthal JA, Burg MM, Barefoot J, Williams RB, Haney T, Zimet G: Social support, type A behavior, and coronary artery disease. Psychosom Med 1987;49:331–340.
  26. ENRICHD Investigators: Enhancing recovery in coronary heart disease patients. Study design and methods. Am Heart J 2000;139:1–9.

    External Resources

  27. Vaglio J Jr, Conard M, Poston WS, et al: Testing the performance of the ENRICHD social support instrument in cardiac patients. Health Qual Life Outcomes 2004;2:24.
  28. Berwick DM, Murphy JM, Goldman PA, Ware JE Jr, Barsky AJ, Weinstein MC: Performance of a five-item mental health screening test. Med Care 1991;29:169–176.
  29. McHorney CA, Ware JE Jr, Raczek AE: The MOS 36-Item Short-Form Health Survey (SF-36). II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 1993;31:247–263.
  30. SAS Online Doc, Version 9.1.3. Cary, SAS Institute Inc, 2004.
  31. Comijs HC, Penninx BW, Knipscheer KP, van Tilburg W: Psychological distress in victims of elder mistreatment: the effects of social support and coping. J Gerontol B Psychol Sci Soc Sci 1999;54:240–245.

    External Resources

  32. Litty CG, Kowalski R, Minor S: Moderating effects of physical abuse and perceived social support on the potential to abuse. Child Abuse Negl 1996;20:305–314.
  33. Fagan J: Contributions of family violence research to criminal justice policy on wife assault: paradigms of science and social control. Violence Vict 1988;3:159–186.