Late Life Domestic Violence

1. Late Life Domestic Violence Charles P. Mouton, MD, MS Department of Community and Family Medicine Howard University College of Medicine

2. BACKGROUND Internationally, 1-8 % of older adults are victims of violence. About 4% of the US elderly have suffered abuse (Pillemer and Finklehor) 820,000 -1.9 million experience maltreatment annually (Tatara, Toshio and Lisa Kuzmeskus,, 1997). Derived from APS stats Women are victims in 2/3 of reported elder abuse cases

3. Background 8-12 million women are at risk of domestic violence (DV) 2-4 million annually 20-28% of older women report having been abused at some point

6. BACKGROUND(cont.) Most data on elder mistreatment are on frail, functionally dependent victims Little is known about effect of elder abuse on functionally independent older adults. Must extrapolate from spousal abuse and elder abuse/neglect literature Particularly true for ethnic minority elders

7. OVERVIEW OF RESEARCH To understand the prevalence and incidence of late life domestic violence in older women To understand the health effects of LLDV and violence across the lifespan Hopefully demonstrating the health effects will encourage greater attention on the part of clinicians

8. WHI OVERVIEW Purpose: A three component study CT: a RCT of HRT, LFD, VitD/Ca on CVD, Cancer, Osteoporosis OS: a prospective cohort study of the same endpoints Community Component Setting: The Women�s Health Initiative (WHI) sites. Participants: Over 93,000 women greater than 50 who are part of the Observational Study of the WHI across 40 clinical research centers in the US

9. WHI Overview Subjects recruited through mass mailing, media advertisements, Subjects completed interviewer administered questionnaires Participants in the DV ancillary study completed my Domestic Violence Screening Questionnaire separately

10. METHODS Setting: The Women�s Health Initiative (WHI) sites. Participants: Over 93,000 women greater than 50 who are part of the Observational Study of the WHI across 40 clinical research centers in the US.

11. WHI MEASUREMENTS Self-reported exposure to physical abuse �Over the past year, were you physically abused by being hit, slapped, pushed, shoved, punched or threatened with a weapon by a family member or close friend?� Self-reported exposure to verbal abuse �Over the past year, were you verbally abused by being made fun of, severely criticized, told you were a stupid or worthless person, or threatened with harm to yourself, your possessions, or your pets, by a family member or close friend?� Response Categories: No Yes, not upset Yes, moderately upset Yes, very upset

13. Domestic Violence (cont.) Health status assessed by the PCS and MCS of the SF-36

14. Results (DV on health perceptions) Prevalence of Physical abuse = 1.24% Prevalence of Verbal abuse = 10.94% Age, Ethnicity, Education, Family Income, Occupation, Marital Status and Partner�s Job associated with both

15. Results (continued) Incidence of Physical abuse = 0.68% Incidence of Verbal abuse = 7.1% Age, Ethnicity, Education, Family Income, Occupation, Marital Status and Partner�s Job associated with incidence of both

16. Study wide Results: Physical Abuse