Dyer Carmel Bitondo, Franzini Luisa, Watson Mary, Sanchez Luis, Prati Laura, Mitchell Stacy, Wallace Robert, Pickens Sabrina
Department of Internal Medicine, Division of Geriatrics, Baylor College of Medicine, Houston, Texas, USA.
J Am Geriatr Soc. 2008 Nov;56 Suppl 2:S261-5. doi: 10.1111/j.1532-5415.2008.01978.x.
In almost every U.S. jurisdiction, elder self-neglect is the most common allegation addressed by Adult Protective Service (APS) agencies. Not only is self-neglect common, but this form of mistreatment is an independent risk factor for death. A lack of understanding of the precipitating factors and root causes and of the effect on social and medical systems persists in this field. Research in this area has been limited, because the needs of these vulnerable elderly people are complex and diverse. Moreover, these factors encompass interrelated medical, psychiatric, economic, social, and functional problems. In 2004, the National Institutes of Health Interdisciplinary Roadmap Initiative provided the means for preliminary exploration of elder self-neglect through the formation of the Consortium for Research in Elder Self-neglect of Texas (CREST). The goals of CREST include to conduct pilot studies, form interdisciplinary working groups, convene a national research conference, and appoint a national external advisory board. CREST orchestrated the work of 35 interdisciplinary investigators to achieve these goals. CREST researchers have begun to characterize the population of vulnerable elderly people who were reported to APS for neglecting themselves. The pilot studies provided a snapshot of 100 elderly people who had neglected themselves. A proposed next phase could involve a prospective longitudinal study of elderly people with severe self-neglect. This study of the clinical course, the death rate, the causes of death, the occurrence of acute and chronic medical or mental illness, and the costs to the healthcare and social systems would greatly inform the field of elder mistreatment.
在美国几乎每个司法管辖区，老年人自我忽视都是成人保护服务（APS）机构处理的最常见指控。自我忽视不仅常见，而且这种虐待形式是导致死亡的一个独立风险因素。在这个领域，人们对引发因素、根本原因以及对社会和医疗系统的影响仍然缺乏了解。该领域的研究一直有限，因为这些弱势老年人的需求复杂多样。此外，这些因素包括相互关联的医疗、精神、经济、社会和功能问题。2004年，美国国立卫生研究院跨学科路线图倡议通过组建德克萨斯州老年人自我忽视研究联盟（CREST），为初步探索老年人自我忽视提供了途径。CREST的目标包括开展试点研究、组建跨学科工作组、召开全国性研究会议以及任命一个全国性外部咨询委员会。CREST精心组织了35名跨学科研究人员的工作以实现这些目标。CREST的研究人员已开始对那些因自我忽视而被报告给APS的弱势老年人群体进行特征描述。试点研究提供了100名自我忽视老年人的情况概况。提议的下一阶段可能涉及对严重自我忽视老年人的前瞻性纵向研究。这项关于临床病程、死亡率、死亡原因、急慢性疾病或精神疾病的发生情况以及医疗和社会系统成本的研究将极大地为老年人虐待领域提供信息。
