Keck School of Medicine of USC, University of Southern California, Los Angeles, California, USA.
Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA.
J Am Geriatr Soc. 2021 Aug;69(8):2252-2261. doi: 10.1111/jgs.17192. Epub 2021 May 4.
Physical elder abuse affects a substantial number of older adults, leaving victims at increased risk for negative health outcomes. Improved detection of abuse-related injuries may increase victim access to professional support, but providers report difficulties distinguishing between accidental and abuse-related injuries, due in part to victims' pre-existing health conditions and medication use.
To describe the spectrum and characteristics of injuries among physically abused older adults and identify injury characteristics associated with abuse.
Case-control study.
Physically abused adult protective services clients were interviewed in their home; non-abused comparison group participants were interviewed in an outpatient geriatrics clinic.
Sample included 156 community-dwelling adults aged 65 and older, including 57 physically abused and 99 non-abused individuals. Self-reported abuse history was confirmed through independent case assessment by a LEAD (Longitudinal, Expert All-Data) panel of clinicians with family violence expertise.
Full-body assessments were conducted, documenting injury incidence, diagnosis, and location. We also collected sociodemographic characteristics, level of social support, functional ability, medical history, and medication use.
Physically abused older adults were more likely to be injured upon assessment (79.0% vs 63.6%; p < 0.05) and have a greater number of injuries ( vs , p < 0.05). Injuries seen more often among abused individuals included: upper extremity ecchymoses (42.1% vs 26.3%; p < 0.05), abrasions (31.6% vs 11.1%; p < 0.01), and areas of tenderness (8.8% vs 0.0%; p < 0.01); and head/neck/maxillofacial ecchymoses (15.8% vs 2.0%; p < 0.01) and tenderness (15.8% vs 0.0%; p < 0.001). Lower extremity abrasions (12.3%) were common but unrelated to abuse status.
While physical abuse does not always result in physical injury, victims more commonly display head/neck/maxillofacial ecchymoses or tenderness and upper extremity abrasions, ecchymoses, or tenderness. Detection of these injuries among older adults warrants further interview and examination.
身体虐待会影响到大量老年人，使受害者面临更多负面健康后果的风险。更好地发现与虐待相关的伤害可能会增加受害者获得专业支持的机会，但由于受害者先前存在的健康状况和用药情况，提供者报告说难以区分意外和与虐待相关的伤害。
描述身体受虐老年人的伤害范围和特征，并确定与虐待相关的伤害特征。
病例对照研究。
在受虐的成年人保护服务客户的家中对其进行访谈；非受虐的对照组参与者在老年病门诊进行访谈。
样本包括 156 名 65 岁及以上的社区居住成年人，其中 57 名身体受虐，99 名非受虐。通过具有家庭暴力专业知识的 LEAD（纵向、专家全数据）小组的独立案例评估，确认了自我报告的虐待史。
进行全身评估，记录伤害发生率、诊断和位置。我们还收集了社会人口统计学特征、社会支持程度、功能能力、病史和用药情况。
身体受虐的老年人在评估时更有可能受伤（79.0%比 63.6%；p<0.05），受伤的次数也更多（13.9 比 10.0；p<0.05）。在受虐者中更常见的伤害包括：上肢瘀斑（42.1%比 26.3%；p<0.05）、擦伤（31.6%比 11.1%；p<0.01）和压痛部位（8.8%比 0.0%；p<0.01）；以及头/颈/颌面瘀斑（15.8%比 2.0%；p<0.01）和压痛（15.8%比 0.0%；p<0.001）。下肢擦伤（12.3%）很常见，但与虐待状况无关。
虽然身体虐待并不总是导致身体伤害，但受害者更常见的表现为头/颈/颌面瘀斑或压痛，以及上肢擦伤、瘀斑或压痛。在老年人中发现这些伤害需要进一步的访谈和检查。
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