Prevalence of suspected abuse of non-institutionalized older people treated in primary care. PRESENCIA study

Abstract

Objectives

To determine the prevalence of suspected abuse of non-institutionalised elderly people and the associated variables.

Patients and method

Observational, descriptive, cross-sectional, multicentre study in patients aged 65 years or older, non-institutionalised, consecutively selected in primary care (PC). The EASI questionnaires (Suspected Elderly Abuse Index), the EAI questionnaire (Suspected Abuse Index in patients with cognitive impairment), the Barthel index, and the EUROQOL-5D questionnaire were used with patients, and the CASE questionnaire and the Zarit test were used with caregivers. Socio-demographic, health, and quality of life variables were analysed in all patients.

Results

Eight hundred four patients were included, mean age 78.9 ± 7.9 years, 58.3% women. The prevalence of suspected abuse was 11.3% (95% CI: 9.1%–13.9%). Suspected abuse was more frequent in women than in men (14.4% vs. 7.1%; odds ratio (OR) = 1.97; 95% CI = 1.1–3.4; p = 0.016) and in those who lived with two or more people compared to those who lived alone (18.4% vs. 7.3%; OR = 2.42; 95% CI = 1.1–5.0; p = 0.017).

Among older patients, the lower their dependency, the lower the prevalence of suspected abuse (30.0% in highly dependent vs. 8.7% in non-dependent: p-trend = 0.006); and the better the perceived health status, the lower the prevalence of suspected abuse (29.6% in poor health status vs. 6.9% in optimal health status; p-trend = <0.001).

Among caregivers, the prevalence of suspected abuse was 20.4% (95% CI = 12.8%–28.0%). A trend of higher prevalence of suspected abuse could be observed with higher scores on the CASE questionnaire (56.3% at high risk and 9.6% with no risk of abuse; p-trend = 0.007). In the case of the ZARIT questionnaire with scores below 47, the prevalence of suspected abuse was 9.1%, and for scores above 55, it was 52.6% (p-trend < 0.001).

Conclusions

The results of the PRESENCIA study show that approximately 1 in 10 patients aged ≥65 meet the criteria for suspected abuse. The probability of abuse increases in women, in patients with greater dependency and in patients with poorer perceived health status. Caregivers with greater overload and greater risk presented a greater suspicion of elder abuse.