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Elder Self‐Neglect and Hospitalization: Findings from the Chicago Health and Aging Project
Author(s) -
Dong XinQi,
Simon Melissa A.,
Evans Denis
Publication year - 2012
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2011.03821.x
Subject(s) - medicine , neglect , gerontology , medicaid , confounding , population , confidence interval , socioeconomic status , poisson regression , rate ratio , activities of daily living , demography , psychiatry , health care , environmental health , pathology , sociology , economics , economic growth
Objectives To quantify the relation between reported elder self‐neglect and rate of hospitalization in a community population of older adults. Design Prospective population‐based study. Setting Geographically defined community in C hicago. Participants Community dwelling older adults who participated in the C hicago Health and Aging Project. One thousand one hundred sixty‐five of the 6,864 participants in the C hicago Health and Aging Project was reported to social services agency for suspected elder self‐neglect. Measurements The primary predictor was elder self‐neglect reported to social services agency. The outcome of interest was the annual rate of hospitalization, obtained from the Centers for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships. Results The average annual rate of hospitalization was 0.6 ± 1.3 for participants without elder self‐neglect and 1.8 ± 3.2 for those with reported elder self‐neglect. After adjusting for sociodemographic and socioeconomic characteristics, medical commorbidities, and cognitive and physical function, older adults who neglected themselves had significantly higher rate of hospitalization (rate ratio = 1.47, 95% confidence interval = 1.39–1.55). Greater severity of self‐neglect (mild: standardized parameter estimate ( PE ) = 0.24, standard error (0.05); moderate: PE = 0.45 (0.03); severe: PE = 0.54, (0.11), all P < .001) was associated with higher annual rates of hospitalization after adjusting for the same confounders. Interaction term analyses suggest that medical conditions, cognitive impairment, and physical disability did not mediate the significant relationship between self‐neglect and hospitalization. Conclusion Reported elder self‐neglect was associated with higher rates of hospitalization in this community population. Greater severity of self‐neglect was associated with a greater rate of hospitalization.