The Relationship Between Abuse of Older People and Cognitive Functioning: A Scoping Review

Emerging evidence suggests that abuse of older people (AOP) and cognitive functioning are closely intertwined. AOP has been linked to an increased risk of cognitive impairment, while impaired cognition may also elevate vulnerability to AOP. However, to date, no study has reviewed these relationships in both directions, particularly their potential bidirectionality. Thus, we conducted a scoping review to summarize and critically evaluate the existing studies examining the relationship between AOP and cognitive functioning. We searched four databases (Social Work Abstract-Academic Search Premier, PAIS Index, APA PsycINFO, and PubMed) for English peer-reviewed observational articles published from database inception through June 4, 2024. Eligible studies examined associations between at least one domain of cognition and AOP. Of the 3,817 records identified, 29 articles (23 cross-sectional, 6 longitudinal) using 27 unique studies met the inclusion criteria. Overall, most studies reported negative associations between AOP and cognitive functioning in both directions, suggesting a possible bidirectional relationship. Specifically, 14 of the 19 articles examining cognitive impairment as a risk factor for AOP reported a significant association between lower cognitive functioning and increased risk of AOP. In the reverse direction, 8 of the 10 articles found that higher AOP was significantly associated with poorer cognitive outcomes. Future longitudinal studies are needed to test the potentially bidirectional relationship between AOP and cognition and to explore the underlying mechanisms, thus informing integrated policies and interventions to concurrently promote cognitive health and address AOP among older adults.