Elder Abuse and Long-Term Health Outcomes: A Comprehensive Meta-Analytic Review

Elder Abuse and Long-Term Health Outcomes: A Comprehensive Meta-Analytic Review Antonietta Porzio, MD*, , Università Degli Studi Della Campania “Luigi Vanvitelli, Italy, Naples, Campania, Italy; Maria Grazia Violante, Università Degli Studi di Bari Aldo Moro, Bari, Puglia, Italy; Carlo Pietro Campobasso, MD, PhD, University of Campania "Luigi Vanvitelli", Naples, Naples, Campania, Italy; Paola Ciamarra, MD, Università Degli Studi Della Campania “Luigi Vanvitelli, Italy, Naples, Campania, Italy; Ignazio Grattagliano, PhD, Università Degli Studi di Bari Aldo Moro, Bari, Puglia, Italy; Graziamaria Corbi, PhD, University of Naples Federico II, Naples, Campania, Italy Learning Objectives: After attending this presentation, attendees will gain an enhanced understanding of the long-term health impacts of elder abuse and major outcomes such as hospitalization, mortality, falls, and depression. Impact Statement: This study highlights the potential long-term consequences of elder abuse on major health outcomes, emphasizing the need for early identification, prevention strategies, and targeted interventions to reduce its impact on the aging population. Abstract Text: With the global population aging, elder abuse has emerged as an increasingly significant public health concern, increased during the COVID-19 pandemic due to extended periods of isolation.1 The World Health Organization (WHO) defines elder abuse as a harmful act or omission within a relationship of trust, encompassing physical, emotional, sexual, and financial abuse, as well as neglect and abandonment.2 Victims may experience severe consequences, including injuries, depression, cognitive decline, premature mortality, and institutionalization.3,4 However, evidence regarding the long-term effects such as hospitalization, falls, mortality, and mental health remains limited. The aim of this study is to review the available literature to determine whether, in the long term, elder abuse could be considered a risk factor for major outcomes. A meta-analysis was performed by searching Medline, Scopus, Web of Science, PubMed, and CENTRAL Cochrane. Studies were eligible whether reporting the development in the long-term of any outcome (hospitalization, death, falls, disability, depressive symptoms) and an available control group. The risk of bias was assessed using GRADE. A p< 0.05 was considered statistically significant. The systematic review consisted of 74,253 screened articles. However, only 25 studies satisfied the inclusion criteria, that included 29,366,038 older subjects. The total population consisted of 42,637 older abused and 29,323,401 not abused subjects. At least one outcome was present in 11,005 victims and in 10,115,628 non-abused subjects. In a random-effects method, the abuse favored (p< 0.0001) the development of any outcome, whereas the data suffered from high heterogenicity (I2=94.09%). So, sub-analyses were performed to assess the possible factors affecting this relationship. Abuse appears to be linked to a higher risk of developing outcomes, and despite high heterogeneity and data variability, the findings are statistically significant. Addressing elder abuse requires interventions to improve detection, raise awareness, reduce victims’ mental health symptoms, and prevent abuse. Risk factors like health conditions, caregiver burden, and social isolation increase vulnerability. The awareness of these factors could guide future research and preventive strategy in protecting older adults, References: 1. Eurostat. Life expectancy at birth, 2023. Eurostat website. Published May 3, 2024. Accessed July 1, 2025. https://ec.europa.eu/eurostat/web/productseurostat- news/w/ddn-20240503-2. 2. World Health Organization (WHO). The Toronto Declaration on the Global Prevention of Elder Abuse. WHO website. Published 2002. Accessed July 1, 2025. http://www.who.int/ageing/publications/toronto_declaration/en/. 3. Dong X, Simon MA. Elder abuse as a risk factor for hospitalization in older persons. JAMA Intern Med. 2013;173(10):911-917. doi:10.1001/jamainternmed.2013.238. 4. Lachs MS, Williams CS, O’Brien S, Pillemer KA, Charlson ME. The mortality of elder mistreatment. JAMA. 1998;280(5):428-432. doi:10.1001/jama.280.5.428.