Associations between the differential definitions of elder mistreatment and suicidal ideation outcomes in U.S. Chinese older adults: Do the definitions matter?

Abstract

Background: Elder mistreatment (EM) prevalence varies greatly according to definitional criteria. However, little is known regarding the significance of different EM definitions with respect to health outcome. This paper explores the association between different definitions of EM and their subtypes and suicidal ideation (SI) in an U.S. Chinese aging population. Methods: The Population Study of ChINese Elderly in Chicago Study was conducted from 2011 to 2013 of 3157 community-dwelling Chinese older adults aged 60 years. Psychological, physical mistreatment (PM), caregiver neglect (CN), financial exploitation (FE), and overall EM were measured by different definitional approaches varying in the strictness. SI in the past 2 weeks and 12 months were assessed. Results: After adjusting for confounders, the least restrictive EM definition (odds ratio [OR], 2.10 [1.34–3.28]; OR, 2.43 [1.66–3.55]), moderately restrictive EM definition (OR, 2.87 [1.80–4.56]; OR, 2.71 [1.82–4.04]), and most restrictive EM definition (OR, 2.24 [1.36–3.66]; OR, 2.34 [1.54–3.56]) were associated with increased risk for 2-week and 12-month SI. For subtypes of EM, psychological mistreatment (the least and most restrictive definitions, 2-week SI: OR, 2.83 [1.71–4.68]; OR, 3.13 [1.10–8.91]; 12-month SI: OR, 2.43 [1.56–3.78]; OR, 2.88 [1.10–7.54]), PM (2-week SI: OR, 5.12 [1.83–14.29]; 12-month SI: OR, 3.45 [1.30–9.13]), and FE was not associated with 2-week SI, only the broadly defined FE (OR, 1.73 [1.01–2.96]) was associated with higher odds of reporting 12-month SI. CN was only associated with higher odds of reporting 12-month SI (OR, 2.17 [1.19–3.96]; OR, 1.94 [1.24–3.04]) but not 2-week SI. Conclusion: EM and its subtypes were significantly associated with SI; some associations varied by definitions and subtypes.