Ruijia Chen

Elder Abuse and Psychological Well-Being: A Systematic Review and Implications for Research and Policy - A Mini Review

Elder abuse and psychological distress are both important geriatric syndromes and are independently associated with premature morbidity and mortality. Despite recent advances, there has been little systematic exploration of the association between elder abuse and psychological distress. This systematic review synthesizes the qualitative and quantitative studies on the relationship between elder abuse and psychological distress, namely psychological distress as a risk factor and/or a consequence of elder abuse. Moreover, through this review, future research directions for elder abuse and psychological distress and their implications for practice and policy to improve the health and aging of vulnerable populations are also highlighted.

Prevalence and Correlates of Elder Mistreatment in a Community-Dwelling Population of U.S. Chinese Older Adults

Objective: This study aimed to examine the prevalence and correlates of elder mistreatment among U.S. Chinese older adults. Method: Data were drawn from the Population-Based Study of ChINese Elderly (PINE) study, a population-based epidemiological survey of 3,159 U.S. Chinese older adults in the Greater Chicago area. The study design was guided by a community-based participatory research approach. Results: This study found a prevalence of 15.0% for elder mistreatment among community-dwelling Chinese older adults. In addition, higher levels of education (r = .16, p< .001), fewer children (r = .1, p< .001), lower health status (r = .11, p< .001), poorer quality of life (r = .05, p< .01), and worsening health over the past year (r = .08, p< .001) were positively correlated with any elder mistreatment. Discussion: Elder mistreatment is prevalent among U.S. Chinese older adults. The findings point to a pressing need for researchers, community service workers, health care providers, and policy makers to increase efforts on reducing elder mistreatment in U.S. Chinese communities.

Elder Abuse And Dementia: A Review Of The Research And Health Policy

Older adults with dementia may be at high risk for abuse, but the topic has not been well studied. We conducted a literature review to examine the relationships between elder abuse and dementia. We found that psychological abuse was the most common form of abuse among older adults, with estimates of its prevalence ranging from 27.9 percent to 62.3 percent. Physical abuse was estimated to affect 3.5-23.1 percent of older adults with dementia. We also found that many older adults experienced multiple forms of abuse simultaneously, and the risk of mortality from abuse and self-neglect may be higher in older adults with greater levels of cognitive impairment. We summarize programs and policies related to the abuse of older adults with dementia, including adult protective services, mandatory elder abuse reporting, and the Long-Term Care Ombudsman Program. We also summarize aspects of the National Alzheimers Project Act, the Older Americans Act, and the Elder Justice Act. In spite of a recent increase in research and policy developments on elder abuse, challenges such as insufficient funding, limited knowledge about elder abuse, a lack of funding for the implementation of federal and state programs relevant to elder abuse and dementia, and a lack of dementia-specific training for front-line health care staff persist. Stronger programs targeting the well-being of older adults with dementia are needed.

Understanding Depressive Symptoms Among Community-Dwelling Chinese Older Adults in the Greater Chicago Area:

Objective: This study aimed to examine the prevalence of depressive symptoms among U.S. Chinese older adults. Method: Data were from the Population Study of Chinese Elderly in Chicago (PINE) study, a population-based survey of U.S. Chinese older adults aged 60 years and above. The Patient Health Questionnaire (PHQ-9) was used to examine depressive symptoms. Results: Of the 3,159 community-dwelling Chinese older adults, 1,717 (54.4%) reported having any depressive symptoms in the last 2 weeks. Older age (r = .09), being female (r = .10), lower income (r = .09), not being married (r = .07), having fewer years in the United States (r = .05), lower overall health status (r = .32), poorer quality of life (r = .14), and worsening health over the past year (r = .24) were significantly and positively correlated with any depressive symptoms. Discussion: Depressive symptoms are common among U.S. Chinese older adults in the Greater Chicago area. Further longitudinal studies should be conducted to better understand risk factors and outcomes of depressive symptoms among U.S. Chinese older adults.

The perception of social support among U.S. Chinese older adults: findings from the PINE Study.

Objective: This study examined perceptions and correlates of both positive and negative social support among U.S. Chinese older adults. Method: Data were drawn from the Population Study of Chinese Elderly in Chicago study, a population-based study of U.S. community-dwelling Chinese older adults aged 60 years and above in the Greater Chicago area. Results: The findings suggested that U.S. Chinese older adults were more likely to perceive positive and negative spouse and family support than friend support. Younger age, being female, higher levels of education, being married, living with a larger number of people, higher health status, better quality of life, and improved health over the past year were positively associated with positive social support. However, younger age, being male, higher levels of education, being married, having fewer children and grandchildren, living with more people, lower health status, and poorer quality of life were positively correlated with negative social support. Discussion: Chinese older adults perceive a high level of both positive and negative spouse and family support simultaneously. Further longitudinal studies should be conducted to better understand the factors and outcomes associated with perceived positive and negative social support.

Suicidal ideation in an older U.S. Chinese population.

Objective: This study examined the prevalence and correlates of suicidal ideation among U.S. Chinese older adults. Method: Guided by the community-participatory research approach, the PINE (Population Study of Chinese Elderly in Chicago) study is a population-based epidemiological study conducted from 2011 to 2013 of 3,159 community-dwelling Chinese adults aged 60 years and above in the Greater Chicago area. Results: The 2-week prevalence of suicidal ideation, 12-month prevalence of suicidal ideation, and lifetime suicidal ideation were 3.5%, 4.8%, and 9.4%, respectively. Age, sex, marital status, education, income, living arrangement, country of origin, years in the United States, overall health status, quality of life, and health changes over the past year were significantly correlated with suicidal ideation. Discussion: Suicidal ideation was common among U.S. Chinese older adults in the Greater Chicago area. Further longitudinal studies should be conducted to explore the risk and protective factors associated with suicidal ideation.

Association between Elder Mistreatment and Suicidal Ideation among Community-Dwelling Chinese Older Adults in the USA

Background: Elder mistreatment and suicidal ideation are important public health concerns among aging populations. However, very few studies have been conducted to explore the association between elder mistreatment and suicidal ideation. Objectives: To examine the association between elder mistreatment and suicidal ideation among Chinese older adults in the USA. Methods: Guided by a community-based participatory research approach, in this study we conducted in-person interviews with Chinese older adults aged 60 years and older in the Greater Chicago area from 2011 to 2013. Elder mistreatment was assessed by a 10-item instrument derived from the Hwalek-Sengstock Elder Abuse Screening Test (H-S/EAST) and the Vulnerability to Abuse Screening Scale (VASS). Suicidal ideation was assessed by the ninth item of the Patient Health Questionnaire-9 (PHQ-9) and the Geriatric Mental State Examination-Version A (GMS-A). Results: Overall, 3,159 Chinese older adults participated in this study, and their mean age was 72.8 years. After controlling for age, gender, education, income, medical comorbidities, depressive symptoms, and social support, elder mistreatment was significantly associated with 2-week suicidal ideation (OR 2.46, 95% CI 1.52-4.01) and 12-month suicidal ideation (OR 2.46, 95% CI 1.62-3.73). With respect to gender differences, the study found that the association remained significant for older women but not for older men after adjusting for all confounding factors. Conclusion: As the largest epidemiological study conducted among Chinese older adults in the USA, this study suggests that elder mistreatment is significantly associated with 2-week and 12-month suicidal ideation in older women but not in older men. Longitudinal studies should be conducted to explore the mechanisms through which elder mistreatment links with suicidal ideation.

The Prevalence of Medical Conditions Among U.S. Chinese Community-Dwelling Older Adults

BACKGROUND The burden of medical conditions is increasing among U.S. older adults, yet we have very limited knowledge about medical conditions among Chinese older adults in the United States. This study aimed to examine the prevalence of medical conditions and its sociodemographic and health-related correlates within the context of a population-based cohort study of U.S. Chinese older adults. METHOD Using a community-based participatory research approach, community-dwelling Chinese older adults aged 60 years and older in the Greater Chicago area were interviewed between 2011 and 2013. RESULTS Of the 3,159 participants interviewed, 58.9% were female and the mean age was 72.8 years. In total, 84.3% of older adults had one or more medical condition, 24.6% reported two conditions, 19.5% had three conditions, and 17.0% reported four or more conditions. A sizeable percentage of older adults had never been screened for dyslipidemia (24.4%) or had never been screened for diabetes mellitus (35.7%).For those who reported high cholesterol, 73.0% were taking medications when compared with 76.1% of those who reported having diabetes and 88.3% of those who reported having high blood pressure. Various sociodemographic and health-related characteristics were correlated with medical conditions. CONCLUSION Medical conditions were common among U.S. Chinese older adults, yet screening and treatment rates were fairly low. Future longitudinal studies should be conducted to better understand the risk and protective factors associated with medical conditions.

The Association Between Filial Piety and Suicidal Ideation: Findings From a Community-Dwelling Chinese Aging Population

BACKGROUND Suicidal ideation is a public health issue that has a significant impact at the individual, family, community, and societal levels. This study aimed to examine the association between filial piety and suicidal ideation among U.S. Chinese older adults. METHODS Guided by a community-based participatory research approach, 3,159 community-dwelling Chinese older adults in the Greater Chicago area were interviewed in person between 2011 and 2013. Independent variables were expectations and receipt of filial piety from the older adults perspective. Dependent variables were suicidal ideation in the last 2 weeks and last 12 months. Logistic regression analyses were performed. RESULTS Of the 3,159 participants interviewed, 58.9% were female and the mean age was 72.8 years. After adjusting for age, sex, education, income, medical comorbidities, and depressive symptoms, lower receipt of filial piety was associated with increased risk for 2-week suicidal ideation (odds ratio: 1.07, 95% confidence interval: 1.03-1.11) and 12-month suicidal ideation (odds ratio: 1.07, 95% confidence interval: 1.04-1.11). The lowest tertiles of filial piety receipt was associated with greater risk for 2-week suicidal ideation (odds ratio: 1.95, 95% confidence interval: 1.12-3.38) and 12-month suicidal ideation (odds ratio: 2.17, 95% confidence interval: 1.35-3.48). However, no statistically significant associations were found between overall filial piety expectations and suicidal ideation in the last 2 weeks or in the last 12 months. DISCUSSION This study suggests that filial piety receipt is an important risk factor for suicidal ideation among U.S. Chinese older adults. Future longitudinal studies are needed to quantify the temporal association between filial piety and suicidal ideation.

Anxiety Among Community-Dwelling U.S. Chinese Older Adults

BACKGROUND This study aimed to explore the prevalence and correlates of anxiety disorders and any anxiety symptoms among community-dwelling U.S. Chinese older adults. METHODS Guided by a community-based participatory research approach, 3,159 community-dwelling Chinese older adults in the Greater Chicago area were interviewed in person between 2011 and 2013. RESULTS Of 3,159 older adults surveyed, 8.5% had anxiety disorders and 65.0% reported having any anxiety symptoms. Being female, unmarried, poorer health status, lower quality of life, and worsening health over the past year were positively correlated with anxiety disorders and any anxiety symptoms. Living with fewer people and having fewer children were only correlated with any anxiety symptoms and lower income was only correlated with anxiety disorders. CONCLUSIONS This study emphasizes that interventions for anxiety among Chinese older adults should give special attention to older women, those who are unmarried, with impaired health status, and poorer quality of life. Further longitudinal studies should be conducted to better understand risk factors and outcomes associated with anxiety among U.S. Chinese older adults.