WITHDRAWN: Psychological Well-Being and Incidents of Elder Abuse Among U.S. Chinese Older Adults: Longitudinal Evidence

Background and Purpose: Due to the great paucity of longitudinal data on elder abuse, incident elder abuse and its risk factors remain poorly understood, particularly in racial/ethnic minority populations. An improved understanding of longitudinal psychological risk factors associated with elder abuse through representative population-based studies is fundamental in developing evidence-based prevention and intervention programs for the rapidly growing ethnic minority populations. Especially, the increasing diversity in the aging population warrants systematic investigations regarding ethnic differences related to psychological well-being and elder abuse. To bridge this knowledge gap, this longitudinal study examined the relationship between psychological well-being and incidents of elder abuse among U.S. Chinese older adults, representing one of the largest and fastest growing older minority populations nationwide. We hypothesized that both baseline and declined psychological well-being are positively associated with incidents of elder abuse over two years.

Methods: Data were drawn from the Population-based Study of Chinese Elderly in Chicago (PINE), a longitudinal, representative, population-based study of community-dwelling Chinese older adults in the Greater Chicago area. We analyzed survey responses from 2,713 participants who completed both the baseline interviews between 2011 and 2013 and follow-up interviews after a two-year interval (between 2013 and 2015). Incidents of elder abuse were defined as new cases of elder abuse, measured by the number of respondents who reported negative at baseline and positive to any elder abuse subtypes at follow-up interviews using a 56-item elder abuse questionnaire. Psychological well-being included depressive symptoms (Patient Health Questionnaire), loneliness (Revised University of California at Los Angeles Loneliness Scale), anxiety (Hospital Anxiety and Depression Scale), hopelessness (Beck Hopelessness Scale), and perceived stress (Perceived Stress Scale). Declined psychological well-being was calculated by comparing the Wave 1 and Wave 2 scores. Logistic regression models were conducted to examine the relationships, controlling for potential cofounders.

Results: The two-year incidence rate of elder abuse was 6.4%. Higher levels of anxiety (odds ratio [OR]=1.09, 95% confidence interval [CI]=1.02-1.15), hopelessness (OR=1.04, 95% CI=1.01-1.08), and perceived stress (OR=1.06, 95% CI=1.03-1.09) at baseline were associated with higher odds of the incidents of elder abuse. Baseline depressive symptoms and loneliness were not significantly associated with incidents of elder abuse. Moreover, compared to those whose psychological well-being did not change over two years, participants with worsened depressive symptoms (odds ratio [OR]=2.34, 95% confidence interval [CI]=1.57-3.49), anxiety (OR=2.38, 95% CI=1.55-3.65), loneliness (OR=2.56, 95% CI=1.74-3.78), and perceived stress (OR=2.19,95% CI=1.02-4.68) were more likely to experience incidents of elder abuse. Change in hopelessness was not significantly associated with incidents of elder abuse (OR=1.76, 95% CI=0.83-3.73).

Conclusions and Implications: The findings suggest that psychological wellbeing represents a significant risk factor for elder abuse among U.S. Chinese older adults. Consequently, health and social service professionals serving Chinese older adults should pay attention to emotional symptoms in identifying those who are at a greater risk for elder abuse or those who may be experiencing abuse. Future research should identify other risk factors for elder abuse in diverse populations to develop tailored prevention strategies to protect vulnerable elder abuse victims.