Mental Health Outcomes Associated with Elder Abuse: A Systematic Review and Meta-Analysis

Despite consistent evidence linking elder abuse to adverse mental health outcomes, quantitative estimates remain limited. This study aimed to conduct a systematic review and meta-analysis focusing on the negative mental health consequences associated with elder abuse. A comprehensive search was performed across Web of Science, PubMed, Embase, PsycINFO, and Scopus for peer-reviewed quantitative studies examining elder abuse as an independent variable and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)-defined mental health outcomes among adults aged ≥60, published up to January 2024. A total of 23 studies comprising 73 effect sizes that met the inclusion criteria were reviewed. The meta-analyses revealed that older adults who experienced abuse were at a significantly higher risk of adverse mental health outcomes, with a pooled odds ratio (OR) of 2.524 (95% CI [2.300, 2.769]), including depression (OR = 2.833 [2.419, 3.319]), anxiety (OR = 2.495 [2.000, 3.113]), suicidal ideation (OR = 2.249 [1.827, 2.769]), and sleep problems (OR = 2.368 [1.827, 3.070]). Despite evidence of publication bias, trim-and-fill adjustments moderately reduced effect sizes (overall: adjusted OR = 2.197; depression: adjusted OR = 2.094, sleep problems: adjusted OR = 1.732) without affecting robustness. Sensitivity analyses confirmed that results were stable after removing individual studies. Findings are primarily generalizable to community-dwelling older adults due to limited institutional data. Moderator analyses for anxiety outcomes should be interpreted with caution, given covariance among study-level factors. This is the first quantitative synthesis of elder abuse and mental health outcomes, emphasizing the need for targeted interventions and policies to mitigate these risks.