Elder Abuse and Chronic Pain: Cross‐Sectional and Longitudinal Results from the Preventing Elder Abuse and Neglect Initiative

• Published in: Journal of the American Geriatrics Society (JAGS) 2018-06, Vol.66 (6), p.1165-1171
• Main Authors: Yunus, Raudah M, Hairi, Noran N, Choo, Wan Y, Tan, Maw P, Hairi, Farizah, Sooryanarayana, Rajini, Ismail, Norliana, Kandiben, Shatanapriya, Peramalah, Devi, Ali, Zainudin M, Ahmad, Sharifah N, Razak, Inayah A, Othman, Sajaratulnisah, Mydin, Fadzilah HM, Chinna, Karuthan, Bulgiba, Awang
• Format: Article
• Language: English
• Subjects: Abuse; Adult abuse & neglect; Causality; Chronic pain; Drug abuse; elder abuse and neglect; elder mistreatment; elderly abuse; Experimental allergic neuritis; Gait; Geriatrics; Longitudinal studies; longitudinal study; Older people; Pain; Prevention
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/jgs.15370

Objectives To examine the cross‐sectional and longitudinal relationships between elder abuse and neglect (EAN) and chronic pain in rural older Malaysians. Design Two‐year prospective cohort study. Setting Kuala Pilah, a district in Negeri Sembilan approximately 100 km from the capital city, Kuala Lumpur. Participants Community‐dwelling older adults aged 60 and older. Using a multistage cluster sampling strategy, 1,927 respondents were recruited and assessed at baseline, of whom 1,189 were re‐assessed 2 years later. Measures EAN was determined using the modified Conflict Tactic Scale, and chronic pain was assessed through self‐report using validated questions. Results The prevalence of chronic pain was 20.4%. Cross‐sectional results revealed 8 variables significantly associated with chronic pain—age, education, income, comorbidities, self‐rated health, depression, gait speed, and EAN. Abused elderly adults were 1.52 times as likely to have chronic pain (odds ratio=1.52, 95% confidence interval (CI)=1.03–2.27), although longitudinal analyses showed no relationship between EAN and risk of chronic pain (risk ratio=1.14, 95% CI=0.81–1.60). This lack of causal link was consistent when comparing analysis with complete cases with that of imputed data. Conclusion Our findings indicate no temporal relationship between EAN and chronic pain but indicated cross‐sectional associations between the two. This might indicate that, although EAN does not lead to chronic pain, individuals with greater physical limitations are more vulnerable to abuse. Our study also shows the importance of cohort design in determining causal relationships between EAN and potentially linked health outcomes.