Health Conditions in Older Adults Suspected of Being Maltreated: A 20-Year Real-World Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Variables
2.3. Data Sources/Measurement
2.4. Bias
2.5. Statistical Methods
3. Results
4. Discussion
4.1. Risk Factors
4.2. Traumatic Injuries and Intoxications
4.3. Mental Health Disorders
4.4. Physical Disorders
4.5. The Role of Health Professionals in OAM
4.6. Limitations of This Study and Further Research
5. Conclusions
- At the LHUM, between 2001 and 2021, 3092 older adults aged 60 years or more were identified as suspected victims of maltreatment, which represents only 4.5% of the total older adult population analysed (n = 68,094);
- Physicians at the LHUM more often record suspected victims of OAM using clinical notes than clinical codes;
- Suspected cases appeared to increase with age;
- Considering the health risk factors evaluated, suspected victims of OAM had higher rates of alcohol consumption;
- The risk of OAM appeared to increase with poverty;
- Suspected victims of OAM had more health problems than the total older adult population at the LHUM over the same period. Compared to the total population, the suspected victims of OAM had higher rates of:
- (a)
- Traumatic injuries, such as bone fractures and dislocations (1.4 and 1.9 times higher, respectively), and superficial injuries (1.5 times higher);
- (b)
- Intoxications (1.7 times higher);
- (c)
- Mental disorders, such as major psychiatric disorders, posttraumatic stress disorder, and dementia (1.5, 1.5, and 2.0 times higher, respectively), as well as other mental health disorders, namely, sleep disorders, memory disorders, psychosocial stress, and social deprivation (1.3, 1.7, 1.2, and 1.9 times higher, respectively);
- (d)
- Suicidal ideation (2.0 times higher);
- (e)
- Medication consumption, including antidepressants, antipsychotics, anxiolytics, and sedatives (1.3, 1.7, 1.1, and 1.3 times higher, respectively);
- (f)
- Cardiovascular disorders, such as myocardial infarction, stable angina, unstable angina, transient ischaemic attack, and heart failure (1.8, 1.7, 1.4, 1.4, and 2.1 times higher, respectively);
- (g)
- Cerebrovascular events, namely, ischaemic and haemorrhagic stroke (1.9 and 2.9 times higher, respectively);
- (h)
- Chronic immune inflammatory disorder and asthma (1.6 and 1.3 times higher, respectively);
- (i)
- Other physical disorders included metabolic (type 2 diabetes and non-alcoholic fatty liver disease, which were 1.3 and 2.0 times higher, respectively), respiratory (chronic obstructive pulmonary disease, which was 1.6 times higher), and genitourinary disorders (chronic kidney disease and urinary tract infection, which were 1.5 and 1.4 times higher, respectively).
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Total Older Adult Population | Suspected of OAM | ||
---|---|---|---|
G1 (Codes + Clinical Notes) | G2 (Codes) | G3 (Notes) | |
68,094 (100) | 3092 (4.5) | 638 (0.9) | 2478 (3.6) |
Total Population | G1 | Ratio | |
---|---|---|---|
Tobacco | 5205 (7.6) | 247 (8.0) | 1.1 |
Alcohol | 1596 (2.3) | 111 (3.6) | 1.6 |
Total Population | G1 | Ratio | |
---|---|---|---|
Bone fracture | 30,980 (45.5) | 1924 (62.2) | 1.4 |
Open wound | 22,027 (32.4) | 1468 (47.5) | 1.5 |
Intoxication | 14,816 (21.8) | 1160 (37.5) | 1.7 |
Burns | 5542 (8.1) | 503 (16.3) | 2.0 |
Bone dislocation | 4776 (7.0) | 411 (13.3) | 1.9 |
Superficial injury | 4743 (7.0) | 409 (13.2) | 1.8 |
Crushing injury | 1181 (1.7) | 88 (2.9) | 1.7 |
Total Population | G1 | Ratio | |
---|---|---|---|
Major psychiatric disorder | 29,381 (43.2) | 1958 (63.3) | 1.5 |
Psychosocial stress | 17,417 (25.6) | 977 (31.6) | 1.2 |
Sleep disorders | 10,302 (15.1) | 591 (19.1) | 1.3 |
Dementia | 5898 (8.7) | 541 (17.5) | 2.0 |
Alzheimer’s | 1148 (1.7) | 97 (3.1) | 1.8 |
Vascular | 882 (1.3) | 105 (3.4) | 2.6 |
Memory disorders | 4614 (6.8) | 353 (11.4) | 1.7 |
Social deprivation | 1022 (1.5) | 88 (2.9) | 1.9 |
Posttraumatic stress disorder | 147 (0.2) | 10 (0.3) | 1.5 |
Suicide ideation | 100 (0.2) | 12 (0.4) | 2.0 |
Anxiolytics | 44,280 (65.0) | 2283 (73.8) | 1.1 |
Antidepressants | 31,707 (46.6) | 1811 (58.6) | 1.3 |
Sedative | 19,085 (28.0) | 1100 (35.6) | 1.3 |
Antipsychotics | 12,146 (17.8) | 957 (31.0) | 1.7 |
Total Population | G1 | Ratio | |
---|---|---|---|
Metabolic syndrome | 62,958 (92.5) | 2998 (97.0) | 1.1 |
Type 2 diabetes | 29,412 (43.2) | 1706 (55.2) | 1.3 |
Hypercholesterolemia | 24,033 (35.3) | 1031(33.3) | 0.9 |
Obesity | 14,407 (21.1) | 621 (20.0) | 0.9 |
Non-alcoholic fatty liver disease | 2440 (3.6) | 233 (7.5) | 2.0 |
Cardiovascular disease | 54,884 (80.6) | 2784 (90.0) | 1.1 |
Hypertension | 47,612 (70.0) | 2225 (72.0) | 1.0 |
Structural heart disease | 14,014 (20.6) | 1079 (34.9) | 1.7 |
Atherosclerotic disease | 13,981 (20.5) | 1082 (35.0) | 1.7 |
Stroke | 9183 (13.5) | 800 (25.9) | 1.9 |
Ischaemic | 7621 (11.2) | 685 (22.2) | 1.9 |
Haemorrhagic | 955 (1.4) | 112 (3.6) | 2.6 |
Atrial fibrillation | 8429 (12.4) | 716 (23.2) | 1.9 |
Microvascular disease | 5163 (7.6) | 396 (12.8) | 1.7 |
Angina, stable | 4554 (7.0) | 318 (10.3) | 1.7 |
Angina, unstable | 2189 (3.2) | 142 (4.6) | 1.4 |
Peripheral artery disease | 4339 (6.4) | 324 (10.5) | 1.6 |
Heart failure (latest stage) | 3866 (5.7) | 374 (12.1) | 2.1 |
Myocardial infarction | 3619 (5.3) | 288 (9.3) | 1.8 |
Transient ischaemic attack | 1001 (1.5) | 65 (2.1) | 1.4 |
Early heart disease | 749 (1.1) | 48 (1.6) | 1.5 |
Chronic obstructive pulmonary disease | 4970 (7.3) | 355 (11.5) | 1.6 |
Asthma | 3257 (4.8) | 188 (6.1) | 1.3 |
Chronic immune inflammatory disorder | 1694 (2.5) | 122 (4.0) | 1.6 |
Chronic kidney disease | 14,895 (21.9) | 1010 (32.7) | 1.5 |
Urinary tract infection | 2303 (3.4) | 142 (4.6) | 1.4 |
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Graça, H.; Frazão, S.L.; Magalhães, T.; Vieira-Pinto, P.; Gomes, J.C.; Taveira-Gomes, T. Health Conditions in Older Adults Suspected of Being Maltreated: A 20-Year Real-World Study. J. Clin. Med. 2023, 12, 5247. https://doi.org/10.3390/jcm12165247
Graça H, Frazão SL, Magalhães T, Vieira-Pinto P, Gomes JC, Taveira-Gomes T. Health Conditions in Older Adults Suspected of Being Maltreated: A 20-Year Real-World Study. Journal of Clinical Medicine. 2023; 12(16):5247. https://doi.org/10.3390/jcm12165247
Chicago/Turabian StyleGraça, Hugo, Sofia Lalanda Frazão, Teresa Magalhães, Paulo Vieira-Pinto, Joana Costa Gomes, and Tiago Taveira-Gomes. 2023. "Health Conditions in Older Adults Suspected of Being Maltreated: A 20-Year Real-World Study" Journal of Clinical Medicine 12, no. 16: 5247. https://doi.org/10.3390/jcm12165247