Shen Yan, Sun Fei, Feng Yali, Lichtenberg Peter A, Meng Hongdao
School of Economic and Management and Law, Hubei Normal University, Huangshi, China,
School of Social Work, Michigan State University, East Lansing, Michigan, USA.
Gerontology. 2025;71(5):400-416. doi: 10.1159/000543804. Epub 2025 Mar 28.
Individuals with dementia are at an elevated risk for abuse and neglect. This study aimed to estimate pooled prevalence rates of elder abuse among community-dwelling individuals with dementia using a meta-analytic approach. Additionally, it explored the heterogeneity associated with prevalence estimates through subgroup analyses.
In line with the Cochrane guidelines, searches were conducted across eight academic online databases, reference lists of eligible studies, and existing systematic reviews. Eligible studies are studies published between January 1990 and March 2023 that report elder abuse among people with dementia (PWD) in community settings. The final review included 30 eligible studies from eight countries, encompassing a sample of 6,789 dependent/carer dyads.
The pooled rate of overall abuse among older adults with dementia is 42.6% (95% CI: 0.34-0.51). Among the various forms of abuse, psychological abuse was most prevalent, occurring in 44.8% of cases (95% CI: 0.37, 0.52), followed by financial abuse (28.3%, 95% CI: 0.03, 0.53), neglect (19.8%, 95% CI: 0.09, 0.34), and physical abuse (10%, 95% CI: 0.07, 0.13).
The high prevalence of elder abuse highlights the significant vulnerability of individuals with dementia. The highest rate of psychological abuse indicates a particular need to address emotional trauma of PWD, as well as to adopt measures to reduce abusive or neglectful behaviors via caregiver education and support.
患有痴呆症的个体遭受虐待和忽视的风险较高。本研究旨在采用荟萃分析方法估计社区居住的痴呆症患者中老年人虐待的合并患病率。此外,通过亚组分析探讨了与患病率估计相关的异质性。
按照Cochrane指南,在八个学术在线数据库、符合条件的研究的参考文献列表以及现有的系统评价中进行检索。符合条件的研究是1990年1月至2023年3月期间发表的,报告社区环境中痴呆症患者(PWD)遭受老年人虐待情况的研究。最终综述纳入了来自八个国家的30项符合条件的研究,涵盖6789对受抚养者/照顾者样本。
患有痴呆症的老年人中总体虐待的合并发生率为42.6%(95%CI:0.34 - 0.51)。在各种虐待形式中,心理虐待最为普遍,发生率为44.8%(95%CI:0.37,0.52),其次是经济虐待(28.3%,95%CI:0.03,0.53)、忽视(19.8%,95%CI:0.09,0.34)和身体虐待(10%,95%CI:0.07,0.13)。
老年人虐待的高发生率凸显了痴呆症患者的显著脆弱性。心理虐待的最高发生率表明,特别需要解决痴呆症患者的情感创伤问题,并通过照顾者教育和支持采取措施减少虐待或忽视行为。