Sensory Impairment and Risk of Elder Mistreatment in Community-Dwelling Older Adults

Emotional and financial mistreatment among older adults is often under-recognized among clinicians. Exploring whether sensory impairment is linked to an elevated risk of elder financial or emotional mistreatment could help inform targeted screening strategies.

We used nationally-representative, cross-sectional data from the National Social Life, Health, and Aging Project, including interview rounds with available assessments of recent elder mistreatment (Round 1 (R1): 2005-06 and Round 4 (R4): 2021-23). Elder mistreatment included reported emotional mistreatment (being insulted or feeling controlled) and financial mistreatment (money or belongings taken without permission) within the last 12 months. Assessments of sensory impairment differed slightly by round of data collection and included self-reported overall vision, olfaction, and hearing, self-reported hearing loss that interferes with communication, and objective vision (visual acuity) and olfaction (sniff test). We used multivariable logistic regressions to determine the association of self-reported and objective individual and multi-sensory impairments with mistreatment risk. Analyses for multisensory impairment were conducted using the full sample, while analyses for individual impairments were stratified by round of data collection.

The total sample included 5231 participants; R1 included 2461 participants who were on average 70 years old (SD 7) and 53% female, and R4 included 2770 participants who were on average 71 years old (SD 9) and 55% female. Multisensory impairment was linked to a higher adjusted probability of experiencing either emotional or financial mistreatment (0 impairments: 20% vs. 1 impairment: 23% vs. 2+ impairments: 28%, p < 0.01). Respondents with self-reported vision impairment had a higher adjusted probability of financial mistreatment (8% vs. 3%, p < 0.001) whereas objective vision impairment had no association. Self-reported hearing impairment that interfered with communication was associated with financial mistreatment (12% vs. 7%, p = 0.03).

Integrating assessments for multisensory impairment, vision, and hearing loss may add to elder mistreatment prevention and detection efforts.