Elder abuse as a risk factor for psychological distress among older adults in India: a cross-sectional study

Abstract

Objectives: This study examines the association between elder abuse and psychological distress among older adults in India, and explores whether this association varies by the level of psychosocial and material resources. Design: The study uses a cross-sectional survey design. Setting The data are drawn from a representative sample of 9,589 adults aged 60 and above in seven Indian states - Himachal Pradesh, Punjab, West Bengal, Odisha, Maharashtra, Kerala and Tamil Nadu – in 2011. Statistical analyses: Secondary analysis, using bi-variate and multivariate logistic regression models, is conducted using the UNFPA project Building Knowledge Base on Ageing in India (BKPAI) survey. Elder abuse (physical and/or emotional) emanating from family members in the previous month before the survey is examined. Multivariate models are run on the total analytical sample, and for men and women separately. Results: The overall prevalence of psychological distress amongst persons aged 60 and over living in the seven Indian States is 40.6 percent. Among those older persons who experienced some form of physical or emotional abuse or violence in the last month, the prevalence of psychological distress is much higher than that in the general older population, at 61.6 percent (P<0.001). The results show that the experience of abuse is negatively associated with the mental health of older adults, and this relationship persists even after controlling for demographic and socio-economic factors (OR=1.60, 95% CI=1.22-2.09). The findings also suggest that household wealth has an inverse relationship with mental health, with the association between experiencing elder abuse and reporting poor mental health being strongest amongst older people in wealthy households. Conclusions: Elder abuse in India is currently a neglected phenomenon, and greater recognition of the link between abuse and mental health is critical in order to improve the well-being of vulnerable older adults, some of whom may be ‘hidden’ within well-off households.

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Identifiers

ORCID for Maria Evandrou: orcid.org/0000-0002-2115-9358

ORCID for Jane Falkingham: orcid.org/0000-0002-7135-5875

ORCID for Min Qin: orcid.org/0000-0002-5941-9979

ORCID for Athina Vlachantoni: orcid.org/0000-0003-1539-3057

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