Easton Scott D, Kong Jooyoung
Boston College School of Social Work, Chestnut Hill, Massachusetts.
Sandra Rosenbaum School of Social Work, University of Wisconsin, Madison.
J Gerontol B Psychol Sci Soc Sci. 2021 Nov 15;76(10):2086-2097. doi: 10.1093/geronb/gbaa095.
Elder abuse victimization is increasingly recognized as a pressing public health concern. However, few empirical studies have investigated whether early life course adversities and midlife sequelae heighten risks for abuse in late life. Guided by cumulative disadvantage theory, the current study examined whether compromised health in middle adulthood (physical, psychological, cognitive) mediates the association between child abuse and elder abuse.
This secondary analysis was based on data from the Wisconsin Longitudinal Study, a population-based, multi-wave dataset. We analyzed responses from 5,968 participants (mean age = 71 years; 54% female) on adapted versions of standardized measures: elder abuse victimization (outcome variable), childhood adversities (independent variable), and midlife health (physical health, depressive symptoms, cognitive functioning; mediator variables). Serial multiple mediation models were conducted, controlling for background characteristics.
Rates for any elder abuse and child adversities were, respectively, 16.34% and 47.98%. Multivariate analyses supported the cumulative disadvantage hypothesis. Childhood adversities (0.11, p < .001) and midlife health (physical, -0.10, p < .05; depressive symptoms, 0.09, p < .001; cognitive functioning, 0.02, p < .05) had significant direct effects on elder abuse victimization. Childhood adversities also had an indirect effect on elder abuse through physical health (0.002, p < .05) and depressive symptoms (0.01, p < .001), both in serial.
This innovative study advances our understanding mechanisms through which childhood trauma influences abuse in late life. Boosting health in middle adulthood could help prevent elder abuse. Other implications for clinical practice, treatment, and future research on elder abuse are discussed.
老年人受虐问题日益被视为一个紧迫的公共卫生问题。然而，很少有实证研究调查生命早期的逆境和中年后遗症是否会增加晚年受虐的风险。在累积劣势理论的指导下，本研究考察了中年时期受损的健康状况（身体、心理、认知方面）是否在儿童期受虐与老年人受虐之间的关联中起中介作用。
本二次分析基于威斯康星纵向研究的数据，这是一个基于人群的多波数据集。我们分析了5968名参与者（平均年龄 = 71岁；54%为女性）对标准化测量改编版本的回答：老年人受虐情况（结果变量）、童年逆境（自变量）和中年健康状况（身体健康、抑郁症状、认知功能；中介变量）。进行了系列多重中介模型分析，并控制了背景特征。
任何形式的老年人受虐率和儿童期逆境发生率分别为16.34%和47.98%。多变量分析支持累积劣势假说。童年逆境（0.11，p <.001）和中年健康状况（身体方面，-0.10，p <.05；抑郁症状，0.09，p <.001；认知功能，0.02，p <.05）对老年人受虐情况有显著的直接影响。童年逆境还通过身体健康（0.002，p <.05）和抑郁症状（依次为0.01，p <.001）对老年人受虐产生间接影响。
这项创新性研究推进了我们对童年创伤影响晚年受虐机制的理解。改善中年时期的健康状况有助于预防老年人受虐。还讨论了对老年人受虐的临床实践、治疗及未来研究的其他启示。
