Physical function decline and the risk of elder self-neglect in a community-dwelling population

Abstract

Purpose: This longitudinal study examines the association between physical function decline and the risk of elder self-neglect in a community-dwelling population.

Design and methods: Of the 5,570 participants in the Chicago Health Aging Project, 1,068 were reported to social services agency for suspected elder self-neglect from 1993 to 2005. The primary predictor was objectively assessed physical function using decline in physical performance testing. Secondary predictors were assessed using the decline in self-reported Katz, Nagi, and Rosow-Breslau scales. Outcome of interest was elder self-neglect. Logistic and linear regression models were used to assess these associations.

Results: After adjusting for confounding factors, every 1-point decline in physical performance testing was associated with increased risk of reported elder self-neglect (odds ratio [OR], 1.05, confidence interval [CI], 1.03-1.07, p < .001). Decline in Katz (OR, 1.05, CI, 1.00-1.10, p < .05) and decline in Rosow-Breslau (OR, 1.19, CI, 1.11-1.27, p < .001) were associated with increased risk of reported elder self-neglect. Decline in physical performance testing (standardized parameter estimate [PE]: 0.19, SE: 0.06, p = .002), Katz (PE: 0.65, SE: 0.14, p < .001), Nagi (PE: 0.48, SE: 0.14, p < .001), and Rosow-Breslau (PE: 0.57, SE: 0.21, p = .006) scales were associated with increased risk of greater self-neglect severity.

Implications: Decline in physical function was associated with increased risk of reported elder self-neglect and greater self-neglect severity in this community-dwelling population.

Figure 1.

Decline in physical function and self-neglect severity. The association (with 95% confidence intervals) of decline in levels of physical performance testing and higher number of impairments in self-reported physical function measures (Katz, Nagi, and Rosow–Breslau) and greater self-neglect severity.