目的:老年人滥用,一个重要的人权问题和公共卫生问题,增加了残疾和死亡率。在过去的几十年里,一些综述综合了主要研究以确定其患病率。这项总括性审查旨在估计全球社区和护理环境中虐待老年人的总体患病率。
方法:在PROSPERO(CRD42021281866)进行前瞻性注册后,我们对8个电子数据库进行了搜索,以确定从开始到2023年1月17日的系统评价。计算校正的覆盖面积以估计评论之间初步研究的潜在重叠。使用改良的AMSTAR-2仪器评估所选评论的质量。我们提取了社区和护理环境中任何类型的老年人(60岁或以上的人)虐待的患病率数据。
结果:在2007年至2022年之间检索了16篇系统综述,其中有10篇在全球范围内捕获的患病率,三个在伊朗,一个在土耳其,一个在中国,一个在巴西。这16篇综述共包括1988年至2020年的136项主要研究。综述之间的研究重叠被发现是中等的(5.5%)。评论质量低(2,12.5%)或极低(14,87.5%)。估计全球整体虐待老年人的患病率范围很广(1.1-78%),而对特定滥用率的估计为0-81.8%的忽视,1.1-78.9%的心理虐待,财务滥用占0.7-78.3%,身体虐待占0.1-67.7%,和0-59.2%的性虐待。
结论:尽管证据的低质量和现象的异质性使得很难提供准确的患病率数据,毫无疑问,虐待老年人是一个普遍存在的问题,而且分布广泛。注意力的重点应转向干预措施和决策,以防止这种形式的滥用。
OBJECTIVE: Elder abuse, an important human rights issue and public health problem, contributes to increased disability and mortality. In the last decades, several reviews have synthesized primary studies to determine its prevalence. This umbrella review aimed to estimate the worldwide overall prevalence rate of elder abuse in the community and care setting.
METHODS: Following prospective registration at PROSPERO (CRD42021281866) we conducted a search of eight electronic databases to identify systematic reviews from inception until 17 January 2023. The corrected covered area was calculated to estimate the potential overlap of primary studies between reviews. The quality of the selected reviews was assessed using a modified AMSTAR-2 instrument. We extracted data on the prevalence of any type of elder (people aged 60 years old or older) abuse in the community and care setting.
RESULTS: There were 16 systematic reviews retrieved between 2007 and 2022, out of which ten captured prevalence globally, three in Iran, one in Turkey, one in China and one in Brazil. The 16 reviews included 136 primary studies in total between 1988 and 2020. The overlapping of studies between reviews was found to be moderate (5.5%). The quality of reviews was low (2, 12.5%) or critically low (14, 87.5%). The estimated range of global prevalence of overall elder abuse was wide (1.1-78%), while the estimations of specific abuse prevalence ranged from 0-81.8% for neglect, 1.1-78.9% for psychological abuse, 0.7-78.3% for financial abuse, 0.1-67.7% for physical abuse, and 0-59.2% for sexual abuse.
CONCLUSIONS: Although the low quality of the evidence and the heterogeneity of the phenomenon makes it hard to give precise prevalence data, it is without a question that elder abuse is a prevalent problem with a wide dispersion. The focus of attention should shift towards interventions and policymaking to prevent this form of abuse.