OBJECTIVES:To determine whether elder abuse can predict mortality and disability over the ensuing 12 years. DESIGN:Population-based prospective cohort study of women aged 70 to 75 in 1996; survival analysis. SETTING:Australia. PARTICIPANTS:Twelve thousand sixty-six women with complete data on elder abuse. MEASUREMENTS:Elder abuse was assessed using the 12-item Vulnerability to Abuse Screening Scale (VASS) subscales: vulnerability, coercion, dependence, and dejection. Outcomes were death and disability (defined as an affirmative response to "Do you regularly need help with daily tasks because of long-term illness, disability or frailty?"). RESULTS:In 1996, 8% reported vulnerability, 6% coercion, 18% dependence, and 22% dejection. By October 2008, 3,488 (29%) had died. Mortality was associated with coercion (hazard ratio (HR) = 1.21, 95% confidence interval (CI) = 1.06-1.40) and dejection (HR = 1.12, 95% CI = 1.03-1.23), after controlling for demographic characteristics, social support, and health behavior but not after adding chronic conditions to the coercion model. Over the 12 years, 2,158 of 11,027 women who had reported no disability in 1996 reported disability. Women who reported vulnerability (HR = 1.25, 95% CI = 1.06-1.49) or dejection (HR = 1.55, 95% CI = 1.38-1.73) were at greater risk of disability, after controlling for demographic characteristics, social support, and health behavior. The relationship remained significant for dejection when chronic conditions and mental health were included in the model (HR = 1.40, 95% CI = 1.24-1.58). CONCLUSION:Specific components of vulnerability to elder abuse were differently associated with rates of disability and mortality over the ensuing 12 years.

译文

目的:确定虐待老人是否可以预测接下来的12年内的死亡率和残疾。
设计:1996年基于人群的前瞻性队列研究,研究对象为70至75岁的女性。生存分析。
地点:澳大利亚。
参与者:12.6万名妇女,其中有关于虐待老年人的完整数据。
度量:老年人虐待是使用12个项目的虐待滥用筛查量表(VASS)进行评估的:脆弱性,强迫,依赖性和沮丧感。结果是死亡和残疾(定义为对“您是否因长期生病,残疾或虚弱而经常需要日常工作的帮助吗?”的肯定回答)。
结果:1996年,有8%的人报告了脆弱性,6%的胁迫,18%的依赖和22%的沮丧。截至2008年10月,死亡3,488(29%)。在控制了人口统计学特征,社会支持之后,死亡率与强迫(危险比(HR)= 1.21,95%置信区间(CI)= 1.06-1.40)和沮丧感(HR = 1.12,95%CI = 1.03-1.23)相关。 ,以及健康行为,但不会在强制模型中添加慢性病之后。在过去的12年中,1996年未报告残疾的11027名妇女中有2158人报告了残疾。在控制了人口统计学特征,社会支持和健康之后,报告为脆弱性(HR = 1.25,95%CI = 1.06-1.49)或沮丧(HR = 1.55,95%CI = 1.38-1.73)的女性患残疾的风险更高。行为。当模型中包括慢性病和精神健康时,这种关系对于抑郁症仍然很明显(HR = 1.40,95%CI = 1.24-1.58)。
结论:在随后的12年中,遭受老年人虐待的脆弱性的特定组成部分与残疾率和死亡率有不同的关系。

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