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Interventions for preventing abuse in the elderly.

Philip R A Baker1, Daniel P Francis, Noran N Hairi

  • 1School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia, 4059.

The Cochrane Database of Systematic Reviews
|August 17, 2016
PubMed
Summary
This summary is machine-generated.

Evidence on elder abuse interventions is limited, with high risk of bias in studies. More high-quality research is needed to determine effective prevention and reduction strategies for elder maltreatment.

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Area of Science:

  • Gerontology
  • Public Health
  • Social Sciences

Background:

  • Elder abuse encompasses psychological, physical, sexual abuse, neglect, and financial exploitation, affecting an estimated 10% of older adults.
  • Reported cases of elder abuse significantly underrepresent the actual incidence, highlighting a critical gap in detection and intervention.
  • Elder abuse is linked to severe health consequences, including increased morbidity and premature mortality, underscoring the need for effective interventions.

Purpose of the Study:

  • To evaluate the effectiveness of primary, secondary, and tertiary interventions aimed at preventing or reducing elder abuse in various settings.
  • To explore whether intervention outcomes are influenced by the type of abuse, participant characteristics, intervention setting, or cognitive status.

Main Methods:

  • A comprehensive search of 19 databases across multiple disciplines was conducted, supplemented by organizational website reviews and author consultations.
  • Included study designs encompassed randomized controlled trials (RCTs), cluster-RCTs, quasi-RCTs, before-and-after studies, and interrupted time series with at least 12 weeks of follow-up.
  • Data extraction and risk of bias assessments were performed independently by two reviewers, categorizing interventions into education, risk reduction, policy, legislation, detection, victim support, and perpetrator rehabilitation.

Main Results:

  • Seven studies involving 1924 elderly individuals and 740 others met the inclusion criteria; however, research on rehabilitation, specific policies, and legislation was absent.
  • A high risk of bias was prevalent across the included studies (at least 40%), with significant variability in study designs, settings, and reported outcomes, leading to uncertainty about intervention effectiveness.
  • Evidence regarding the impact of interventions on the occurrence or recurrence of elder abuse was inconclusive, with some studies showing no significant difference or even increased reported abuse.

Conclusions:

  • There is insufficient high-quality evidence to definitively assess the effectiveness of current elder abuse interventions in reducing abuse occurrence or recurrence.
  • While some evidence suggests potential positive effects on caregiver anxiety and depression, further rigorous research, including cost-effectiveness and equity analyses, is essential.
  • Future research should prioritize high-income and low-to-middle-income countries, employ robust methodologies, and include comprehensive assessments of intervention components and their impact.