Department of Physioterapy, Federal University of Rio Grande Do Norte, Avenida Senador Salgado Filho, 3000, Lagoa Nova, Natal, RN, 59064-741, Brazil.
Office of Public Health Studies, University of Hawaii, 2500 Campus Rd., Honolulu, HI 96822, United States.
Arch Gerontol Geriatr. 2018 May-Jun;76:26-33. doi: 10.1016/j.archger.2018.02.002. Epub 2018 Feb 8.
To estimate the prevalence of frailty in older adults in the IMIAS population, to examine associations between lifelong domestic violence and frailty and possible pathways to explain these associations.
A cross-sectional study with 2002 men and women in the International Mobility in Aging Study, aged between 65 and 74 years old living in five cities of Tirana (Albania), Natal (Brazil), Kingston and Saint-Hyacinthe (Canada), and Manizales (Colombia). Domestic physical and psychological violence by family and intimate partner was assessed by the Hurt, Insult, Threaten and Scream (HITS) scale. Fried's phenotype was adopted to define frailty. Logistic regressions were fitted to estimate between frailty and lifelong violence. Mediation analyses using the Preacher and Hayes method was used to examine potential health pathways.
Frailty prevalence varies across cities, being lowest in Saint-Hyacinthe and Kingston, and highest in women in Natal. Women had a higher prevalence in Tirana and Natal. Adjusting for age, sex, education and research city, those reporting childhood physical abuse (CPA) had higher odds of frailty (OR = 1.68; 95% CI: 1.01; 2.78); those who had been exposed to psychological violence by their intimate partner had also higher odds of frailty (OR = 2.07; 95% CI: 1.37; 3.12). CPA effect on frailty was totally mediated by chronic conditions and depression symptoms. Effects of psychological violence by intimate partner were partially mediated by chronic conditions and depression symptoms.
Childhood physical abuse and psychological violence during adulthood leave marks on life trajectory, being conducive to adverse health outcomes and frailty in old age.
估计 IMIAS 人群中老年人衰弱的流行率，研究终身家庭暴力与衰弱之间的关联，并探讨可能的解释这些关联的途径。
横断面研究，纳入国际老龄化迁移研究中的 2002 名 65-74 岁的男性和女性，他们居住在 5 个城市：地拉那（阿尔巴尼亚）、纳塔尔（巴西）、金斯敦和圣-海辛特（加拿大）以及马尼萨莱斯（哥伦比亚）。家庭内和伴侣间的身体和心理暴力由伤害、侮辱、威胁和尖叫量表（HITS）评估。采用弗里德表型来定义衰弱。使用逻辑回归来估计衰弱与终身暴力之间的关联。使用 Preacher 和 Hayes 方法进行中介分析，以检验潜在的健康途径。
衰弱的流行率在各城市之间存在差异，圣-海辛特和金斯敦的流行率最低，纳塔尔的女性衰弱的流行率最高。地拉那和纳塔尔的女性衰弱的流行率更高。在调整年龄、性别、教育和研究城市后，报告儿童期身体虐待（CPA）的人衰弱的几率更高（OR=1.68；95%CI：1.01；2.78）；那些曾遭受伴侣心理暴力的人衰弱的几率也更高（OR=2.07；95%CI：1.37；3.12）。CPA 对衰弱的影响完全由慢性疾病和抑郁症状介导。伴侣心理暴力对衰弱的影响部分由慢性疾病和抑郁症状介导。
儿童期身体虐待和成年期的心理暴力会在生命轨迹上留下痕迹，导致老年时出现不良健康结局和衰弱。
