Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Institute for Community Health Research, Hue University, Hue, Vietnam.
PLoS One. 2021 Jul 22;16(7):e0254717. doi: 10.1371/journal.pone.0254717. eCollection 2021.
Childhood adversity has been linked with later victimization of young and middle-aged adults, but few studies have shown persistence of this effect among elders, especially outside of North America. This research examined the association between adverse childhood experiences (ACEs) and elder abuse among older adults aged 60 years and over in Malaysia.
Cross sectional data were collected via face-to-face interview from June to August 2019.
Eight government community health clinics in Kuala Pilah, a district in Negeri Sembilan state approximately 100km from Malaysian capital city Kuala Lumpur.
Older adults aged 60 years and above (N = 1984; Mean age 69.2, range 60-93 years) attending all eight government health clinics in the district were recruited for a face-to-face interview about health and well-being.
The Adverse Childhood Experience International Questionnaire (ACE-IQ) and the Revised Conflict Tactics Scale (CTS) were utilized to estimate childhood adversity and elder abuse respectively.
Multiple logistic regression analysis revealed a significant relationship between the number of cumulative ACEs and elder abuse. Compared to older adults with no self-reported adversity, those reporting three ACEs (OR 2.67, 95% CI 1.84,3.87) or four or more ACEs (OR 1.7, 95% CI 1.16, 2.48) had higher risk of any elder abuse occurrence since age 60 years. The effect was most prominent for financial and psychological elder abuse. The associations persisted in multivariate logistic regression models after adjusting for sociodemographic and health factors.
Early life adversities were significantly associated with victimization of older adults. Social and emotional support to address elder abuse should recognize that, for some men and women, there is a possibility that vulnerability to maltreatment persisted throughout their life course.
童年逆境与年轻和中年成年人后来遭受侵害有关，但很少有研究表明这种影响在老年人中持续存在，尤其是在北美以外的地区。本研究调查了在马来西亚，60 岁及以上老年人中，不良童年经历（ACE）与老年虐待之间的关联。
2019 年 6 月至 8 月，通过面对面访谈收集了横断面数据。
雪兰莪州瓜拉庇拉的 8 个政府社区诊所，该地区距离马来西亚首都吉隆坡约 100 公里。
该地区所有 8 个政府卫生诊所的 60 岁及以上老年人（N=1984；平均年龄 69.2 岁，范围 60-93 岁）被招募参加关于健康和幸福的面对面访谈。
使用不良童年经历国际问卷（ACE-IQ）和修订后的冲突策略量表（CTS）分别估计童年逆境和老年虐待。
多变量逻辑回归分析显示，累积 ACE 数量与老年虐待之间存在显著关系。与没有自我报告逆境的老年人相比，报告有 3 项 ACE（OR 2.67，95%CI 1.84,3.87）或 4 项或更多 ACE（OR 1.7，95%CI 1.16,2.48）的老年人，自 60 岁起发生任何老年虐待的风险更高。财务和心理老年虐待的影响最为显著。在调整了社会人口和健康因素后，多元逻辑回归模型仍存在关联。
早期生活逆境与老年人遭受侵害显著相关。针对老年虐待的社会和情感支持应认识到，对于一些男性和女性来说，他们在整个生命过程中都有可能容易受到虐待。
