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. 2014 Jan;62(1):10-5.
doi: 10.1111/jgs.12621.

Vulnerability risk index profile for elder abuse in a community-dwelling

XinQi Dong, Melissa A Simon

Vulnerability risk index profile for elder abuse in a community-dwelling

XinQi Dong et al. J Am Geriatr Soc. 2014 Jan.

Abstract

Objectives: To develop a vulnerability index for elder abuse in a community-dwelling population.

Design: Population-based.

Setting: Geographically defined community in Chicago.

Participants: Community-dwelling older adults (N = 8,157) who participated in the Chicago Health and Aging Project (CHAP); 213 were reported to social services agency for suspected elder abuse.

Measurements: A nine-item vulnerability index for elder abuse was constructed from sociodemographic, health-related, and psychosocial factors. The outcomes of interest were reported and confirmed elder abuse. Logistic regression models were used to determine the accuracy of the index with respect to elder abuse outcomes.

Results: For every 1-point increase in the vulnerability index, there was twice the risk of reported (OR = 2.19,95% confidence interval (CI) = 2.00–2.40) and confirmed(OR = 2.19, 95% CI = 1.94–2.47) elder abuse. Older adults with three to four vulnerability index items had greater risk than the reference group (no elder abuse) of reported (OR = 2.98, 95% CI = 1.98–4.49) and confirmed (OR = 3.90, 95% CI = 2.07–7.36) elder abuse, and the risk of reported (OR = 18.46, 95% CI = 12.15–28.04) and confirmed (OR = 26.79, 95% CI = 14.18–50.61) elder abuse was 18 and 27 times as great, respectively, in older adults with five or more risk index items. Statistically derived receiver operating characteristic (ROC) curves ranged from 0.77 to 0.84 for predicting reported elder abuse and from 0.79 to 0.86 for predicting confirmed elder abuse.

Conclusion: The vulnerability risk index demonstrates value for identifying individuals at risk of elder abuse. Additional studies are needed to validate this index in other community-dwelling populations.

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Conflict of interest statement

Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper.

Drs Dong, Simon declare no conflict of interest.

Figures

Figure 1
Figure 1. Accuracy of the Vulnerability Index for Reported and Confirmed Elder Abuse
Note: In order to measure the accuracy of the elder abuse index using the vulnerability factors, we used the Receiver Operating Characteristic (ROC) curves, which permits the study to contrast the true positive rates (sensitivity) compared to the false positive rate (1 – specificity) and to evaluate the accuracy of the vulnerability index. Index refers to the 9-items vulnerability index as a continuous measure (0–9). Categorical refers to the cummulative impact for each of the 9 items cutoff points as categorical variables. Continous refers to the cummulative impact for each of the 9 items as continuous variables. Areas under the curves for reported elder abuse were 0.77 for index, 0.79 for categorical, and 0.84 for continuous. Areas under the curves for confirmed elder abuse were 0.79 for index, 0.82 for categorical, and 0.86 for contiuous.
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