Elder abuse as a risk factor for psychological distress among older adults in India: a cross-sectional study

Oct 25, 2017BMJ open

Elder abuse linked to mental distress in older adults in India

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Abstract

The overall prevalence of psychological distress among older adults in India is 40.6%.

Among older adults who experienced physical or emotional abuse in the last month, the prevalence of psychological distress is 61.6%.
Experiencing elder abuse is negatively associated with mental health, with an odds ratio of 1.60, indicating a significant increase in the likelihood of poor mental health.
The negative impact of elder abuse on mental health persists after controlling for demographic and socioeconomic factors.
Household wealth is inversely related to mental health, with the strongest association between elder abuse and poor mental health observed among wealthier households.
The findings suggest that elder abuse is a significant yet overlooked issue affecting the mental well-being of older adults in India.

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OBJECTIVES: This study examines the association between elder abuse and psychological distress among older adults in India and explores whether this association varies by the level of psychosocial and material resources.

DESIGN: The study uses a cross-sectional survey design.

SETTING: The data are drawn from a representative sample of 9589 adults aged 60 and above in seven Indian states-Himachal Pradesh, Punjab, West Bengal, Odisha, Maharashtra, Kerala and Tamil Nadu-in 2011.

STATISTICAL ANALYSES: Secondary analysis, using bivariate and multivariate logistic regression models, is conducted using the United Nations Population Fund project Building Knowledge Base on Ageing in India survey. Elder abuse (physical and/or emotional) emanating from family members in the previous month before the survey is examined. Multivariate models are run on the total analytical sample and for men and women separately.

RESULTS: The overall prevalence of psychological distress among persons aged 60 and over living in the seven Indian States is 40.6%. Among those older persons who experienced some form of physical or emotional abuse or violence in the last month, the prevalence of psychological distress is much higher than that in the general older population, at 61.6% (p<0.001). The results show that the experience of abuse is negatively associated with the mental health of older adults, and this relationship persists even after controlling for demographic and socioeconomic factors (OR=1.60, 95% CI 1.22 to 2.09). The findings also suggest that household wealth has an inverse relationship with mental health, with the association between experiencing elder abuse and reporting poor mental health being strongest among older people in wealthy households.

CONCLUSIONS: Elder abuse in India is currently a neglected phenomenon, and greater recognition of the link between abuse and mental health is critical to improve the well-being of vulnerable older adults, some of whom may be 'hidden' within well-off households.

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