The prevalence of elder abuse in China: a systematic review_Chinese Journal of Evidence-Based Medicine

Authors：

TAO Hongxia ^1,2 , JIN Jing ³ , RUAN Haihui ¹ , CHI Junting ¹ , NIU Xiaodan ¹ , ZHANG Jing ¹ ,  WANG Yanhong ¹

1. School of Nursing, Lanzhou University, Lanzhou 730000, P.R.China;
2. Department of Nursing, Gansu Medical College, Pingliang 744000, P.R.China;
3. Department of Respiration, The First Hospital of Lanzhou University, Lanzhou 730000, P.R.China;

Corresponding author：

WANG Yanhong, Email: yanhongwang@lzu.edu.cn

Keywords：

Elder abuse; China; Prevalence; Meta-analysis; Systematic review; Cross-sectional study

DOI：

10.7507/1672-2531.202003104

Video：

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Objective To systematically review the prevalence of elder abuse in China.Methods PubMed, EMbase, Web of Science, CNKI, VIP and WanFang Data databases were electronically searched to collect cross-sectional studies on the prevalence of elder abuse in China from inception to June 2019. Two reviewers independently screened literature, extracted data and assessed risk bias of included studies; then, meta-analysis was performed by R 3.5.1 software.Results A total of 11 cross-sectional studies involving 23 020 subjects were included. The results of meta-analysis showed that the prevalence of abuse among the elderly in China was 20.29% (95%CI 12.9% to 28.9%). The highest prevalence of elder abuse subtype was psychological abuse with 15.06% (95%CI 10.2% to 20.6%). The prevalence rates were 20.1% in male and 23.64% in female. The prevalence rates in individuals aged between 60 to 70, 70 to 80 and above 80 were 19.76%, 22.24% and 29.19%, respectively. Illiterates and non-illiterates were 29.39% and 22.52% respectively. Normal marital status was 28.24%, and abnormal status was 31.38%. The elderly living alone was the highest (50.67%), compared with family residents (39.42%) and elderly living in pension institutions (29.94%). The elderly without chronic diseases (16.05%) was lower than elderly with chronic diseases (25.49%), and elderly having normal capability of daily living (26.89%) was lower than elderly having reduced capability of daily living (48.78%). Urban residents were 18.46%, while rural residents were 19.69%.Conclusions There is a high incidence of elder abuse in China, and it tends to increase with the increase of age. There are certain differences in the prevalence of elder maltreatment among different genders, ages, educational levels, marital status, living forms and spaces, and health conditions. Due to limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusion.

Citation： TAO Hongxia, JIN Jing, RUAN Haihui, CHI Junting, NIU Xiaodan, ZHANG Jing, WANG Yanhong. The prevalence of elder abuse in China: a systematic review. Chinese Journal of Evidence-Based Medicine, 2020, 20(8): 938-944. doi: 10.7507/1672-2531.202003104 Copy

1.	世界卫生组织. 2014年全球预防暴力状况报告. Available at: https://www.who.int/violence_injury_prevention/violence/status_report/2014/zh/.
2.	Dong X, Chen R, Fulmer T, et al. Prevalence and correlates of elder mistreatment in a community-dwelling population of U.S. Chinese older adults. J Aging Health, 2014, 26(7): 1209-1224.
3.	Fang B, Yan E, Chan KL, et al. Elder abuse and its medical outcomes in older Chinese people with cognitive and physical impairments. Int J Geriatr Psychiatry, 2018, 33(8): 1038-1047.
4.	Dong X, Simon MA. Elder abuse as a risk factor for hospitalization in older persons. JAMA Intern Med, 2013, 173(10): 911-917.
5.	Dong X, Simon MA. Association between elder abuse and use of ED: findings from the Chicago Health and Aging Project. Am J Emerg Med, 2013, 31(4): 693-698.
6.	Yon Y, Mikton CR, Gassoumis ZD, et al. Elder abuse prevalence in community settings: a systematic review and meta-analysis. Lancet Glob Health, 2017, 5(2): e147-e156.
7.	Dong X. Elder abuse in Chinese populations: a global review. J Elder Abuse Negl, 2015, 27(3): 196-232.
8.	曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四: 观察性研究的质量评价工具. 中国循证心血管医学杂志, 2012, 4(4): 297-299.
9.	Dong X, Simon MA, Gorbien M. Elder abuse and neglect in an urban Chinese population. J Elder Abuse Negl, 2007, 19(3-4): 79-96.
10.	Leung DY, Lo SK, Leung AY, et al. Prevalence and correlates of abuse screening items among community-dwelling Hong Kong Chinese older adults. Geriatr Gerontol Int, 2017, 17(1): 150-160.
11.	Wang F, Meng LR, Zhang Q, et al. Elder abuse and its impact on quality of life in nursing homes in China. Arch Gerontol Geriatr, 2018, 78: 155-159.
12.	Wang JJ. Psychological abuse and its characteristic correlates among elderly Taiwanese. Arch Gerontol Geriatr, 2006, 42(3): 307-318.
13.	Wu L, Chen H, Hu Y, et al. Prevalence and associated factors of elder mistreatment in a rural community in People's Republic of China: a cross-sectional study. PLoS One, 2012, 7(3): e33857.
14.	Yan E, Tang CSK. Prevalence and psychological impact of Chinese elder abuse. J Interpers Violence, 2001, 16(11): 1158-1174.
15.	Yan E, Tang CSK. Elder abuse by caregivers: a study of prevalence and risk factors in HongKong Chinese families. J Fam Violence, 2004, 19(5): 269-277.
16.	冀云, 李进伟, 魏志霞, 等. 中国老年人遭受虐待现状及应对措施. 中国老年学杂志, 2018, 38(17): 4284-4287.
17.	李春艳. 郴州市老年人伤害现状及影响因素研究. 长沙: 中南大学, 2014.
18.	钱振中, 胡彩云, 宫凤凤, 等. 安徽省某农村地区老年人虐待的流行状况及其影响因素研究. 中华疾病控制杂志, 2016, 20(8): 813-816.
19.	苏普玉, 郝加虎, 熊黎明, 等. 安徽省农村老年人受虐待与忽视现状及其影响因素研究. 中华流行病学杂志, 2011, 32(2): 110-115.
20.	Garre-Olmo J, Planas-Pujol X, López-Pousa S, et al. Prevalence and risk factors of suspected elder abuse subtypes in people aged 75 and older. J Am Geriatr Soc, 2009, 57(5): 815-822.
21.	余山山. 试论我国老年人监护强制报告制度的完善. 法制与社会, 2019, (13): 29-31.
22.	Rosay AB PhD, Mulford CF PhD. Prevalence estimates and correlates of elder abuse in the United States: The National Intimate Partner and Sexual Violence Survey. J Elder Abuse Negl, 2017, 29(1): 1-14.
23.	Conrad KJ, Iris M, Ridings JW, et al. Conceptual model and map of psychological abuse of older adults. J Elder Abuse Negl, 2011, 23(2): 147-168.
24.	Kong J, Jeon H. Functional decline and emotional elder abuse: a population-based study of older Korean adults. J Fam Violence, 2018, 33(1): 17-26.
25.	胡洋. 农村地区老年人虐待流行现状及危险因素分析. 武汉: 华中科技大学, 2011.
26.	Wang JJ, Lin JN, Lee FP. Psychologically abusive behavior by those caring for the elderly in a domestic context. Geriatr Nurs, 2006, 27(5): 284-291.
27.	Burnes D, Pillemer K, Caccamise PL, et al. Prevalence of risk factors for elder abuse and neglect in the community: a population-based study. J Am Geriatr Soc, 2015, 63(9): 1906-1912.
28.	杨萍萍. 老年痴呆家庭照顾者虐待倾向现状及与照顾负担相关性的研究. 重庆: 重庆医科大学, 2013.
29.	魏蒙, 王记文. 中国老年人认知功能减退的性别和城乡差异. 中国老年人认知功能减退的性别和城乡差异, 2019, 33(12): 950-954.
30.	Vandeweerd C, Paveza GJ, Walsh M, et al. Physical mistreatment in persons with Alzheimer's disease. J Aging Res, 2013, 2013: 920324.
31.	Lai DW. Abuse and neglect experienced by aging Chinese in Canada. J Elder Abuse Negl, 2011, 23(4): 326-347.
32.	梁辰. 老年人孤独感现状及影响因素研究. 济南: 山东大学, 2018.
33.	Dong X, Simon MA. Is greater social support a protective factor against elder mistreatment? Gerontology, 2008, 54(6): 381-388.
34.	张莉. 从性别和婚姻状况的角度探讨代际支持对我国老年人抑郁的影响. 华中科技大学学报(社会科学版), 2019, 33(5): 28-38.
35.	Zannettino L, Bagshaw D, Wendt S, et al. The role of emotional vulnerability and abuse in the financial exploitation of older people from culturally and linguistically diverse communities in Australia. J Elder Abuse Negl, 2015, 27(1): 74-89.
36.	Acierno R, Hernandez MA, Amstadter AB, et al. Prevalence and correlates of emotional, physical, sexual, and financial abuse and potential neglect in the United States: the National Elder Mistreatment Study. Am J Public Health, 2010, 100(2): 292-297.
37.	Konda SR, Gonzalez LJ, Johnson JR, et al. Marriage status predicts hospital outcomes following orthopedic trauma. Geriatr Orthop Surg Rehabil, 2020, 11: 1-5.
38.	Giraldo-Rodríguez L, Rosas-Carrasco O, Mino-León D. Abuse in Mexican older adults with long-term disability: national prevalence and associated factors. J Am Geriatr Soc, 2015, 63(8): 1594-1600.
39.	易成栋, 任建宇. 中国老年人居住意愿满足程度及其影响因素. 中国人口科学, 2019, (1): 113-125, 128.
40.	Cohen MS, Halevy-Levin R, Gagin D, et al. Elder abuse in long-term care residences and the risk indicators. Ageing Soc, 2010, 30(6): 1027-1040.
41.	程蕾, 涂英, 邹小芳. “银发浪潮”下护理院校应对医养结合养老服务需求的对策与发展. 中国老年学杂志, 2019, 39(9): 2283-2288.
42.	Brozowski K, Hall DR. Aging and risk: physical and sexual abuse of elders in Canada. J Interpers Violence, 2010, 25(7): 1183-1199.

1. 世界卫生组织. 2014年全球预防暴力状况报告. Available at: https://www.who.int/violence_injury_prevention/violence/status_report/2014/zh/.
2. Dong X, Chen R, Fulmer T, et al. Prevalence and correlates of elder mistreatment in a community-dwelling population of U.S. Chinese older adults. J Aging Health, 2014, 26(7): 1209-1224.
3. Fang B, Yan E, Chan KL, et al. Elder abuse and its medical outcomes in older Chinese people with cognitive and physical impairments. Int J Geriatr Psychiatry, 2018, 33(8): 1038-1047.
4. Dong X, Simon MA. Elder abuse as a risk factor for hospitalization in older persons. JAMA Intern Med, 2013, 173(10): 911-917.
5. Dong X, Simon MA. Association between elder abuse and use of ED: findings from the Chicago Health and Aging Project. Am J Emerg Med, 2013, 31(4): 693-698.
6. Yon Y, Mikton CR, Gassoumis ZD, et al. Elder abuse prevalence in community settings: a systematic review and meta-analysis. Lancet Glob Health, 2017, 5(2): e147-e156.
7. Dong X. Elder abuse in Chinese populations: a global review. J Elder Abuse Negl, 2015, 27(3): 196-232.
8. 曾宪涛, 刘慧, 陈曦, 等. Meta分析系列之四: 观察性研究的质量评价工具. 中国循证心血管医学杂志, 2012, 4(4): 297-299.
9. Dong X, Simon MA, Gorbien M. Elder abuse and neglect in an urban Chinese population. J Elder Abuse Negl, 2007, 19(3-4): 79-96.
10. Leung DY, Lo SK, Leung AY, et al. Prevalence and correlates of abuse screening items among community-dwelling Hong Kong Chinese older adults. Geriatr Gerontol Int, 2017, 17(1): 150-160.
11. Wang F, Meng LR, Zhang Q, et al. Elder abuse and its impact on quality of life in nursing homes in China. Arch Gerontol Geriatr, 2018, 78: 155-159.
12. Wang JJ. Psychological abuse and its characteristic correlates among elderly Taiwanese. Arch Gerontol Geriatr, 2006, 42(3): 307-318.
13. Wu L, Chen H, Hu Y, et al. Prevalence and associated factors of elder mistreatment in a rural community in People's Republic of China: a cross-sectional study. PLoS One, 2012, 7(3): e33857.
14. Yan E, Tang CSK. Prevalence and psychological impact of Chinese elder abuse. J Interpers Violence, 2001, 16(11): 1158-1174.
15. Yan E, Tang CSK. Elder abuse by caregivers: a study of prevalence and risk factors in HongKong Chinese families. J Fam Violence, 2004, 19(5): 269-277.
16. 冀云, 李进伟, 魏志霞, 等. 中国老年人遭受虐待现状及应对措施. 中国老年学杂志, 2018, 38(17): 4284-4287.
17. 李春艳. 郴州市老年人伤害现状及影响因素研究. 长沙: 中南大学, 2014.
18. 钱振中, 胡彩云, 宫凤凤, 等. 安徽省某农村地区老年人虐待的流行状况及其影响因素研究. 中华疾病控制杂志, 2016, 20(8): 813-816.
19. 苏普玉, 郝加虎, 熊黎明, 等. 安徽省农村老年人受虐待与忽视现状及其影响因素研究. 中华流行病学杂志, 2011, 32(2): 110-115.
20. Garre-Olmo J, Planas-Pujol X, López-Pousa S, et al. Prevalence and risk factors of suspected elder abuse subtypes in people aged 75 and older. J Am Geriatr Soc, 2009, 57(5): 815-822.
21. 余山山. 试论我国老年人监护强制报告制度的完善. 法制与社会, 2019, (13): 29-31.
22. Rosay AB PhD, Mulford CF PhD. Prevalence estimates and correlates of elder abuse in the United States: The National Intimate Partner and Sexual Violence Survey. J Elder Abuse Negl, 2017, 29(1): 1-14.
23. Conrad KJ, Iris M, Ridings JW, et al. Conceptual model and map of psychological abuse of older adults. J Elder Abuse Negl, 2011, 23(2): 147-168.
24. Kong J, Jeon H. Functional decline and emotional elder abuse: a population-based study of older Korean adults. J Fam Violence, 2018, 33(1): 17-26.
25. 胡洋. 农村地区老年人虐待流行现状及危险因素分析. 武汉: 华中科技大学, 2011.
26. Wang JJ, Lin JN, Lee FP. Psychologically abusive behavior by those caring for the elderly in a domestic context. Geriatr Nurs, 2006, 27(5): 284-291.
27. Burnes D, Pillemer K, Caccamise PL, et al. Prevalence of risk factors for elder abuse and neglect in the community: a population-based study. J Am Geriatr Soc, 2015, 63(9): 1906-1912.
28. 杨萍萍. 老年痴呆家庭照顾者虐待倾向现状及与照顾负担相关性的研究. 重庆: 重庆医科大学, 2013.
29. 魏蒙, 王记文. 中国老年人认知功能减退的性别和城乡差异. 中国老年人认知功能减退的性别和城乡差异, 2019, 33(12): 950-954.
30. Vandeweerd C, Paveza GJ, Walsh M, et al. Physical mistreatment in persons with Alzheimer's disease. J Aging Res, 2013, 2013: 920324.
31. Lai DW. Abuse and neglect experienced by aging Chinese in Canada. J Elder Abuse Negl, 2011, 23(4): 326-347.
32. 梁辰. 老年人孤独感现状及影响因素研究. 济南: 山东大学, 2018.
33. Dong X, Simon MA. Is greater social support a protective factor against elder mistreatment? Gerontology, 2008, 54(6): 381-388.
34. 张莉. 从性别和婚姻状况的角度探讨代际支持对我国老年人抑郁的影响. 华中科技大学学报(社会科学版), 2019, 33(5): 28-38.
35. Zannettino L, Bagshaw D, Wendt S, et al. The role of emotional vulnerability and abuse in the financial exploitation of older people from culturally and linguistically diverse communities in Australia. J Elder Abuse Negl, 2015, 27(1): 74-89.
36. Acierno R, Hernandez MA, Amstadter AB, et al. Prevalence and correlates of emotional, physical, sexual, and financial abuse and potential neglect in the United States: the National Elder Mistreatment Study. Am J Public Health, 2010, 100(2): 292-297.
37. Konda SR, Gonzalez LJ, Johnson JR, et al. Marriage status predicts hospital outcomes following orthopedic trauma. Geriatr Orthop Surg Rehabil, 2020, 11: 1-5.
38. Giraldo-Rodríguez L, Rosas-Carrasco O, Mino-León D. Abuse in Mexican older adults with long-term disability: national prevalence and associated factors. J Am Geriatr Soc, 2015, 63(8): 1594-1600.
39. 易成栋, 任建宇. 中国老年人居住意愿满足程度及其影响因素. 中国人口科学, 2019, (1): 113-125, 128.
40. Cohen MS, Halevy-Levin R, Gagin D, et al. Elder abuse in long-term care residences and the risk indicators. Ageing Soc, 2010, 30(6): 1027-1040.
41. 程蕾, 涂英, 邹小芳. “银发浪潮”下护理院校应对医养结合养老服务需求的对策与发展. 中国老年学杂志, 2019, 39(9): 2283-2288.
42. Brozowski K, Hall DR. Aging and risk: physical and sexual abuse of elders in Canada. J Interpers Violence, 2010, 25(7): 1183-1199.

Chinese Journal of Evidence-Based Medicine

The prevalence of elder abuse in China: a systematic review

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