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Vol. 58, No. 3, 2012
Issue release date: April 2012
Section title: Behavioural Science Section / Original Paper
Free Access
Gerontology 2012;58:258–268
(DOI:10.1159/000334256)

Prevalence of Self-Neglect across Gender, Race, and Socioeconomic Status: Findings from the Chicago Health and Aging Project

Dong X.a · Simon M.A.b · Evans D.A.a
aRush University Medical Center, and bNorthwestern University Medical Center, Chicago, Ill., USA
email Corresponding Author

Abstract

Background: Self-neglect is the behavior of an elderly person that threatens his/her own health and safety, and it is associated with increased morbidity and mortality. However, the scope of the self-neglect in the community population remains unclear. We examined the prevalence of self-neglect and its specific behaviors of hoarding, hygiene and other environmental hazards in a community-dwelling elderly population. Methods: A population-based cohort study conducted from 2007 to 2010 in a single cycle in a geographically defined community of 4 adjacent neighborhoods in Chicago, Ill., USA. Participant’s personal and home environment was rated on hoarding, personal hygiene, house in need of repair, unsanitary conditions, and inadequate utility. Prevalence estimates were presented across gender, race/ethnicity, education and income levels. Results: There were 4,627 older adults in the cohort. The prevalence of self-neglect and specific personal and environmental hazards varied significantly by race/ethnicity and by levels of education and income. For race/ethnicity, black older adults (men 13.2%; women 10.9%) had a significantly higher prevalence of self-neglect than white older adults (men 2.4%; women 2.6%). For those with less than high school education, the prevalence of the self-neglect was 14.7% in men and 10.9% in women. For those with an annual income of less than USD 15,000, the prevalence of self-neglect was 21.7% in men and 15.3% in women. Conclusion: The prevalence of self-neglect and specific behaviors of hoarding, poor hygiene, and other environmental hazards are higher among black older adults and among those with lower levels of education and income.

© 2011 S. Karger AG, Basel


  

Key Words

  • Self-neglect
  • Hoarding
  • Hygiene
  • Squalor
  • Environmental hazards
  • Population-based study

References

  1. National Center on ELder Abuse Website. NCEA: the basics. http://elderabusecenter.org/pdf/research/apsreport030703.pdf 2006. 6–20–2006.
  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. Pavlou MP, Lachs MS: Could self-neglect in older adults be a geriatric syndrome? J Am Geriatr Soc 2006;54:831–842.
  4. O’Brien J, Thibault J, Turner L, Laird-Fick H: Self-neglect: an overview. J Elder Abuse Negl 1999;11:1–19.
  5. Lachs MS, Williams CS, O’Brien S, Pillemer KA, Charlson ME: The mortality of elder mistreatment. JAMA 1998;280:428–432.
  6. Dong X, Simon M, Mendes de Leon C, Fulmer T, Beck T, Hebert L, et al: Elder self-neglect and abuse and mortality risk in a community-dwelling population. JAMA 2009;302:517–526.
  7. Lachs MS, Williams C, O’Brien S, Hurst L, Horwitz R: Older adults. An 11-year longitudinal study of adult protective service use. Arch Intern Med 1996;156:449–453.
  8. Lachs MS, Williams CS, O’Brien S, Pillemer KA: Adult protective service use and nursing home placement. Gerontologist 2002;42:734–739.
  9. Dong X, Simon MA, Evans DA: Characteristics of elder self-neglect in a biracial population: findings from a population-based cohort. Gerontology 2010;56:325–334.
  10. National Center on Elder Abuse: The National Elder Abuse Incidence Study. Washington, American Public Human Services Association, 1998.
  11. Bienias JL, Beckett LA, Bennett DA, Wilson RS, Evans DA: Design of the Chicago Health and Aging Project (CHAP). J Alzheimers Dis 2003;5:349–355.

    External Resources

  12. Evans DA, Bennett DA, Wilson RS, Bienias JL, Morris MC, Scherr PA, et al: Incidence of Alzheimer disease in a biracial urban community: relation to apolipoprotein E allele status. Arch Neurol 2003;60:185–189.
  13. SAS Institute Inc: SAS OnlineDoc, Version 9.1.3. Cary, SAS Institute, 2004.
  14. Kim HJ, Steketee G, Frost RO: Hoarding by elderly people. Health Soc Work 2001;26:176–184.
  15. Frost RO, Steketee G, Williams L: Hoarding: a community health problem. Health Soc Care Community 2000;8:229–234.
  16. Halliday G, Banerjee S, Philpot M, Macdonald A: Community study of people who live in squalor. Lancet 2000;355:882–886.
  17. Aung K, Burnett J, Smith SM, Dyer CB: Vitamin D deficiency associated with self-neglect in the elderly. J Elder Abuse Negl 2006;18:63–78.

    External Resources

  18. Burnett J, Coverdale JH, Pickens S, Dyer CB: What is the association between self-neglect, depressive symptoms and untreated medical conditions? J Elder Abuse Negl 2006;18:25–34.

    External Resources

  19. Pickens S, Burnett J, Naik AD, Holmes HM, Dyer CB: Is pain a significant factor in elder self-neglect? J Elder Abuse Negl 2006;18:51–61.

    External Resources

  20. Ostchega Y, Harris TB, Hirsch R, Parsons VL, Kington R: The prevalence of functional limitations and disability in older persons in the US: data from the National Health and Nutrition Examination Survey III. J Am Geriatr Soc 2000;48:1132–1135.
  21. Kelley-Moore JA, Ferraro KF: The black/white disability gap: persistent inequality in later life? J Gerontol B Psychol Sci Soc Sci 2004;59:S34–S43.

    External Resources

  22. Ferraro KF, Farmer MM: Double jeopardy, aging as leveler, or persistent health inequality? A longitudinal analysis of white and black Americans. J Gerontol B Psychol Sci Soc Sci 1996;51:S319–S328.
  23. Bulatao RA, Anderson NB: Understanding Racial and Ethnic Differences in Health in Late Life. Ottawa, National Research Council, 2004.
  24. Bengston VL, Schaie KW: Handbook of Theories of Aging. New York, Springer, 2010.
  25. Dong X: Medical implications of elder abuse and neglect. Clin Geriatr Med 2005;21:293–313.

  

Author Contacts

XinQi Dong, MD, MPH
Rush Institute for Health Aging
1645 West Jackson, Suite 675
Chicago, IL 60612 (USA)
Tel. +1 312 942 3350, E-Mail xinqi_dong@rush.edu

  

Article Information

Received: July 15, 2011
Accepted: September 23, 2011
Published online: December 21, 2011
Number of Print Pages : 11
Number of Figures : 1, Number of Tables : 7, Number of References : 25

  

Publication Details

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

Vol. 58, No. 3, Year 2012 (Cover Date: April 2012)

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: Self-neglect is the behavior of an elderly person that threatens his/her own health and safety, and it is associated with increased morbidity and mortality. However, the scope of the self-neglect in the community population remains unclear. We examined the prevalence of self-neglect and its specific behaviors of hoarding, hygiene and other environmental hazards in a community-dwelling elderly population. Methods: A population-based cohort study conducted from 2007 to 2010 in a single cycle in a geographically defined community of 4 adjacent neighborhoods in Chicago, Ill., USA. Participant’s personal and home environment was rated on hoarding, personal hygiene, house in need of repair, unsanitary conditions, and inadequate utility. Prevalence estimates were presented across gender, race/ethnicity, education and income levels. Results: There were 4,627 older adults in the cohort. The prevalence of self-neglect and specific personal and environmental hazards varied significantly by race/ethnicity and by levels of education and income. For race/ethnicity, black older adults (men 13.2%; women 10.9%) had a significantly higher prevalence of self-neglect than white older adults (men 2.4%; women 2.6%). For those with less than high school education, the prevalence of the self-neglect was 14.7% in men and 10.9% in women. For those with an annual income of less than USD 15,000, the prevalence of self-neglect was 21.7% in men and 15.3% in women. Conclusion: The prevalence of self-neglect and specific behaviors of hoarding, poor hygiene, and other environmental hazards are higher among black older adults and among those with lower levels of education and income.

© 2011 S. Karger AG, Basel


  

Author Contacts

XinQi Dong, MD, MPH
Rush Institute for Health Aging
1645 West Jackson, Suite 675
Chicago, IL 60612 (USA)
Tel. +1 312 942 3350, E-Mail xinqi_dong@rush.edu

  

Article Information

Received: July 15, 2011
Accepted: September 23, 2011
Published online: December 21, 2011
Number of Print Pages : 11
Number of Figures : 1, Number of Tables : 7, Number of References : 25

  

Publication Details

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

Vol. 58, No. 3, Year 2012 (Cover Date: April 2012)

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

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


Article / Publication Details

First-Page Preview
Abstract of Behavioural Science Section / Original Paper

Received: 7/15/2011 3:39:24 PM
Accepted: 9/23/2011
Published online: 12/21/2011
Issue release date: April 2012

Number of Print Pages: 11
Number of Figures: 1
Number of Tables: 7

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. National Center on ELder Abuse Website. NCEA: the basics. http://elderabusecenter.org/pdf/research/apsreport030703.pdf 2006. 6–20–2006.
  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. Pavlou MP, Lachs MS: Could self-neglect in older adults be a geriatric syndrome? J Am Geriatr Soc 2006;54:831–842.
  4. O’Brien J, Thibault J, Turner L, Laird-Fick H: Self-neglect: an overview. J Elder Abuse Negl 1999;11:1–19.
  5. Lachs MS, Williams CS, O’Brien S, Pillemer KA, Charlson ME: The mortality of elder mistreatment. JAMA 1998;280:428–432.
  6. Dong X, Simon M, Mendes de Leon C, Fulmer T, Beck T, Hebert L, et al: Elder self-neglect and abuse and mortality risk in a community-dwelling population. JAMA 2009;302:517–526.
  7. Lachs MS, Williams C, O’Brien S, Hurst L, Horwitz R: Older adults. An 11-year longitudinal study of adult protective service use. Arch Intern Med 1996;156:449–453.
  8. Lachs MS, Williams CS, O’Brien S, Pillemer KA: Adult protective service use and nursing home placement. Gerontologist 2002;42:734–739.
  9. Dong X, Simon MA, Evans DA: Characteristics of elder self-neglect in a biracial population: findings from a population-based cohort. Gerontology 2010;56:325–334.
  10. National Center on Elder Abuse: The National Elder Abuse Incidence Study. Washington, American Public Human Services Association, 1998.
  11. Bienias JL, Beckett LA, Bennett DA, Wilson RS, Evans DA: Design of the Chicago Health and Aging Project (CHAP). J Alzheimers Dis 2003;5:349–355.

    External Resources

  12. Evans DA, Bennett DA, Wilson RS, Bienias JL, Morris MC, Scherr PA, et al: Incidence of Alzheimer disease in a biracial urban community: relation to apolipoprotein E allele status. Arch Neurol 2003;60:185–189.
  13. SAS Institute Inc: SAS OnlineDoc, Version 9.1.3. Cary, SAS Institute, 2004.
  14. Kim HJ, Steketee G, Frost RO: Hoarding by elderly people. Health Soc Work 2001;26:176–184.
  15. Frost RO, Steketee G, Williams L: Hoarding: a community health problem. Health Soc Care Community 2000;8:229–234.
  16. Halliday G, Banerjee S, Philpot M, Macdonald A: Community study of people who live in squalor. Lancet 2000;355:882–886.
  17. Aung K, Burnett J, Smith SM, Dyer CB: Vitamin D deficiency associated with self-neglect in the elderly. J Elder Abuse Negl 2006;18:63–78.

    External Resources

  18. Burnett J, Coverdale JH, Pickens S, Dyer CB: What is the association between self-neglect, depressive symptoms and untreated medical conditions? J Elder Abuse Negl 2006;18:25–34.

    External Resources

  19. Pickens S, Burnett J, Naik AD, Holmes HM, Dyer CB: Is pain a significant factor in elder self-neglect? J Elder Abuse Negl 2006;18:51–61.

    External Resources

  20. Ostchega Y, Harris TB, Hirsch R, Parsons VL, Kington R: The prevalence of functional limitations and disability in older persons in the US: data from the National Health and Nutrition Examination Survey III. J Am Geriatr Soc 2000;48:1132–1135.
  21. Kelley-Moore JA, Ferraro KF: The black/white disability gap: persistent inequality in later life? J Gerontol B Psychol Sci Soc Sci 2004;59:S34–S43.

    External Resources

  22. Ferraro KF, Farmer MM: Double jeopardy, aging as leveler, or persistent health inequality? A longitudinal analysis of white and black Americans. J Gerontol B Psychol Sci Soc Sci 1996;51:S319–S328.
  23. Bulatao RA, Anderson NB: Understanding Racial and Ethnic Differences in Health in Late Life. Ottawa, National Research Council, 2004.
  24. Bengston VL, Schaie KW: Handbook of Theories of Aging. New York, Springer, 2010.
  25. Dong X: Medical implications of elder abuse and neglect. Clin Geriatr Med 2005;21:293–313.