Mortality of elder financial and psychological abuse victims in rural Malaysia: a prospective cohort study

ObjectivesTo determine the longitudinal impact of elder financial and psychological abuse on risk of death among older Malaysians.Design7-year prospective cohort study. Baseline data were collected in late 2013 and respondents were followed up in June 2020.SettingKuala Pilah, Negeri Sembilan, Malays...

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Published in:BMJ open 2022-07, Vol.12 (7), p.e061412
Main Authors: Yunus, Raudah Mohd, Hairi, Noran N, Awang, Halima B, Choo, Wan Yuen, Jamaludin, Siti Zaharah, Hairi, Farizah, Samsuddin, Jamali, Mokhtar, Mohammad Mafrukhin, Fauzi, Syed Mohd, Peramalah, Devi, Sooryanarayana, Rajini, Ismail, Norliana, Ali, Zainudin Mohd, Abdul Razak, Inayah, Ahmad, Sharifah Nor, Othman, Sajaratulnisah, Awang Mahmud, Awang Bulgiba
Format: Article
Language:English
Subjects:
Adult abuse & neglect
Adults
Cognition
Cohort analysis
Death & dying
Emotional abuse
GERIATRIC MEDICINE
Interviews
Mortality
Nursing homes
Older people
PREVENTIVE MEDICINE
Public Health
Questionnaires
Risk
Sample size
Victims
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Summary:ObjectivesTo determine the longitudinal impact of elder financial and psychological abuse on risk of death among older Malaysians.Design7-year prospective cohort study. Baseline data were collected in late 2013 and respondents were followed up in June 2020.SettingKuala Pilah, Negeri Sembilan, Malaysia.Participants1927 community-dwelling older adults aged 60 or older randomly sampled from the national census. Individuals with severe cognitive impairment were excluded.Outcome measureMortality data were provided by the Malaysian National Registration Department and linked to respondents’ national identification numbers. Kaplan-Meier curves and Cox regression were used to examine victims’ survival periods and the impact of abuse on risk of death.ResultsOverall, 450 respondents (23.4%) died after 7 years. Among financial and psychological abuse victims, death percentage was 25.8% compared with 23.3% among those who did not experience these types of abuse. Kaplan-Meier curves showed shorter survival among abuse victims, but Cox regression found no significant impact of financial and psychological abuse on mortality risk (HR 1.05, 95% CI 0.78 to 1.41). Among all the variables studied, only cognitive impairment led to higher mortality risk (HR 1.32, 95% CI 1.03 to 1.69).ConclusionOur findings contradict prior empirical studies that supported the link between elder abuse and neglect (EAN) and mortality, even though we focused on two abuse subtypes. Results in this study are more in line with the recently emerging evidence that showed no association between EAN and mortality.
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2022-061412