Original Article

Clinical Characteristics Associated with Physical Violence in the Elderly: A Retrospective Multicenter Analysis

Abstract

Background: Elder abuse is predicted to increase with the rapid population ageing in many countries. Violent injury is influenced by individual factors as well as interpersonal and social relationships, with different manifestations based on changes in the socioeconomic position of older adults. We comparatively investigated the clinical and injury characteristics of physical violence in the elderly with those in another age group.

Methods: We included elderly patients (age ≥65 years) who visited six emergency departments (ED) with violence-induced injuries in 2017. The control group comprised patients aged 45–64 years, selected by 1:2 matching based on hospital and sex. Data were extracted from the National Emergency Department Information System and electronic medical records. Both groups were compared for injury mechanism, injury location, activity during injury, diagnosis, and clinical outcomes.

Results: Among the 316,944 patients who presented to the 6 ED, 89,178 (28.1%) had traumatic injuries, and 1.6% and 4.5% of injuries were sustained due to violence in the ≥65 and 45–64 year age groups, respectively. There were no significant intergroup differences in the perpetrator (P=0.27), body parts affected (P=0.63), and diagnosis (P=0.23), whereas the older adult group had a significantly higher proportion of traumatic injury by fall (P=0.01), at road and traffic facilities (P=0.01), during work (P=0.01), and multiple injuries (P<0.01).

Conclusion: The increase in non-regular workers in the elderly after retirement may have increased the risk of traumatic workplace injuries. As workplace injuries may be a new risk factor for physical violence in the elderly, institutional workplace injury prevention policy is needed.

1. World Health Organization (2014). Global status report on violence prevention 2014. Geneva: World Health Organiza-tion.
2. Dong X, Simon MA (2013). Elder abuse as a risk factor for hospitalization in older persons. JAMA Intern Med, 173: 911–7.
3. Chien W-C, Lin J-D, Lai C-H, et al (2011). Trends in poisoning hospitalization and mortality in Taiwan, 1999-2008: a retro-spective analysis. BMC Public Health, 11: 703.
4. Yon Y, Mikton CR, Gassoumis ZD, et al. (2017). Elder abuse prevalence in com-munity settings: a systematic review and meta-analysis. Lancet Glob Health, 5: e147–56.
5. Lee YK. Analysis and Projection of Chang-es in the Lives of Elderly Koreans. Korea Institute for Health and Social Affairs; 2011.
6. Hosking J, Ameratunga S, Morton S, et al (2011). A life course approach to injury prevention: a “lens and telescope” con-ceptual model. BMC Public Health, 11: 695.
7. Kwak YH, Kim DK, Jang HY (2012). Utili-zation of emergency department by chil-dren in Korea. J Korean Med Sci, 27: 1222–8.
8. Kwon H, Kim YJ, Jo YH, et al (2019). The Korean Triage and Acuity Scale: associa-tions with admission, disposition, mortal-ity and length of stay in the emergency department. Int J Qual Health Care, 31:449–455.
9. United Nations, Department of Economic and Social Affairs, Population Division. World population ageing, 2019: high-lights. New York: United Nations, 2019.
10. Logan JE, Haileyesus T, Ertl A, et al (2019). Nonfatal Assaults and Homicides among Adults Aged ≥60 Years - United States, 2002-2016. MMWR Morb Mortal Wkly Rep, 68: 297–302.
11. Ben-Shlomo Y, Kuh D (2002). A life course approach to chronic disease epidemiolo-gy: conceptual models, empirical chal-lenges and interdisciplinary perspectives. Int J Epidemiol, 31: 285–93.
12. Pinto E (2007). Blood pressure and ageing. Postgrad Med J, 83: 109–14.
13. Choi NG, Choi BY, DiNitto DM, et al. (2019). Fall-related emergency department visits and hospitalizations among com-munity-dwelling older adults: examination of health problems and injury characteris-tics. BMC Geriatr, 19: 303.
14. Fuller GF (2000). Falls in the elderly. Am Fam Physician, 61: 2173.
15. Breslin FC, Smith P (2005). Age-related dif-ferences in work injuries: a multivariate, population-based study. Am J Ind Med, 48: 50–6.
16. OECD (2019). Pensions at a Glance 2019: OECD and G20 Indicators. Paris: OECD Publishing. doi.org/10.1787/b6d3dcfc-en
17. Smith P, Bielecky A, Koehoorn M, et al (2014). Are age-related differences in the consequence of work injury greater when occupational physical demands are high? Am J Ind Med, 57: 438–44.
18. Zwi JA, Lozano RA, World Health Organi-zation (2003). World Report on Violence and Health.
19. Fraade-Blanar LA, Sears JM, Chan KCG, et al. (2017). Relating older workers’ injuries to the mismatch between physical ability and job demands. J Occup Environ Med, 59: 212–21.
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IssueVol 51 No 1 (2022) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijph.v51i1.8296
Keywords
Workplace violence Physical violence Violence

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How to Cite
1.
Lee DH, Han SS, Kim DH, Kim EC, Lee EH, Park JO, Lee CA. Clinical Characteristics Associated with Physical Violence in the Elderly: A Retrospective Multicenter Analysis. Iran J Public Health. 2022;51(1):79-87.