A cross-sectional population-based study of elder self-neglect and psychological, health, and social factors in a biracial community.

OBJECTIVE

Elder self-neglect is an important public health issue; however, its association with psychological, health, and social factors remains unclear. This study aimed to (1) examine the associations between self-neglect severity and psychological, health, and social factors (2) examine the racial/ethnic differences in these associations.

METHODS

We conducted a biracial population-based study in a geographically defined community in Chicago: Chicago Health Aging Project. We identified 1094 persons who had been identified by social services agency as suspected elder self-neglect from 1993 to 2005. Self-neglect severity was assessed on a 0-45 scale. The psychological, health, and social factors were assessed using Center for Epidemiological Studies of Depression (CESD), poor mental health, health status, unhealthy days, poor physical health, days away from usual activities, social network, and social engagement. Linear regression was used to assess associations between self-neglect and psychological, health, and social factors. Interaction terms (Self-neglect x Race) were used to assess the black (non-Hispanic black) and white (non-Hispanic white) differences in these associations.

RESULTS

There were significant associations between self-neglect severity with health and social factors. After adjusting for confounders, greater self-neglect severity was associated with lower health status (PE = 0.001, p = 0.002), higher unhealthy days (PE = 0.139, p < 0.001), poor physical health (PE = 0.141, p < 0.001), and more days away from usual activities (PE = 0.120, p = 0.030). Interaction term (Self-Neglect x Race) indicates black compared with white older adults, had more days away from usual activities (PE = 0.321, p = 0.045) and lower social engagement (PE = -0.04, p = 0.003).

CONCLUSION

Greater self-neglect severity is associated with lower levels of health and social wellbeing. These associations may be stronger for black than white older adults.