The Experts below are selected from a list of 2034 Experts worldwide ranked by ideXlab platform

Xinqi Dong - One of the best experts on this subject based on the ideXlab platform.

  • ELDER Self-Neglect: IMPLICATIONS FOR HEALTH CARE PROFESSIONALS
    2020
    Co-Authors: Xinqi Dong, Melissa A. Simon
    Abstract:

    Elder Self-Neglect refers to the behaviour of an elderly person that threatens his or her own health and safety. Despite the adverse health outcomes associated with Self-Neglect, the majority of cases go unnoticed by health care professionals. This article discusses the epidemiology of Self-Neglect, associated factors, and its consequences. Even though there are significant gaps in research, enough information is known to guide clinical practice. This article presents the practical approaches a health professional can take when a reasonable suspicion of elder Self-Neglect arises. Public health and interdisciplinary team approaches are needed to manage what will be a growing problem as the number of older adults around the world increases.

  • a vulnerability risk index of Self Neglect in a community dwelling older population
    Journal of the American Geriatrics Society, 2020
    Co-Authors: Bei Wang, Todd Beck, Donald R Hoover, Xinqi Dong
    Abstract:

    BACKGROUND: The only way to systematically screen for Self-Neglect among older adults is through in-home observations, which are often difficult and unfeasible for healthcare providers. To fill this gap, we need a robust and efficient prognostication tool to better treat and prevent Self-Neglect among older adults. OBJECTIVES: To develop a predictive index that can be used to assess risk prognostication of the onset of Self-Neglect among community-dwelling older populations. DESIGN: Two waves of longitudinal data from the Chicago Health and Aging Project (CHAP), collected during 2008 to 2012 with approximately 3-year follow-up intervals. SETTING: Non-Hispanic black or non-Hispanic white community-dwelling older adults in three adjacent neighborhoods in Chicago, IL. PARTICIPANTS: A total of 2885 individuals who were participants of the CHAP study. MEASUREMENTS: The main outcomes are incident Self-Neglect cases. A total of 86 potential predictors were considered in the domains of sociodemographic and socioeconomic, general well-being, health behavior, medical health, medicine/healthcare, cognitive function, physical well-being, social well-being, and psychological well-being. RESULTS: The 3-year Self-Neglect incidence rate is 241 (8.4%). A 10-item predictive model (with a c-statistic of 0.76) was developed using stepwise selection in multivariable logistical regression models. After corrections of overfitting by validating in 100 bootstrapping samples, the predictive accuracy of the model dropped to 0.71, suggesting at least moderate overfitting. A point-based risk index was developed based on parameter estimates of each predictive factor in the final logistic model. The index has an area under the receiver operating characteristic curve of 0.76. CONCLUSION: The study developed an efficient index with good predictive ability of Self-Neglect. Further external validation and impact studies are necessary before practitioners can apply this index to determine risk of Self-Neglect among other community aging populations. J Am Geriatr Soc 68:809-816, 2020.

  • A Vulnerability Risk Index of Self‐Neglect in a Community‐Dwelling Older Population
    Journal of the American Geriatrics Society, 2019
    Co-Authors: Bei Wang, Todd Beck, Donald R Hoover, Xinqi Dong
    Abstract:

    BACKGROUND: The only way to systematically screen for Self-Neglect among older adults is through in-home observations, which are often difficult and unfeasible for healthcare providers. To fill this gap, we need a robust and efficient prognostication tool to better treat and prevent Self-Neglect among older adults. OBJECTIVES: To develop a predictive index that can be used to assess risk prognostication of the onset of Self-Neglect among community-dwelling older populations. DESIGN: Two waves of longitudinal data from the Chicago Health and Aging Project (CHAP), collected during 2008 to 2012 with approximately 3-year follow-up intervals. SETTING: Non-Hispanic black or non-Hispanic white community-dwelling older adults in three adjacent neighborhoods in Chicago, IL. PARTICIPANTS: A total of 2885 individuals who were participants of the CHAP study. MEASUREMENTS: The main outcomes are incident Self-Neglect cases. A total of 86 potential predictors were considered in the domains of sociodemographic and socioeconomic, general well-being, health behavior, medical health, medicine/healthcare, cognitive function, physical well-being, social well-being, and psychological well-being. RESULTS: The 3-year Self-Neglect incidence rate is 241 (8.4%). A 10-item predictive model (with a c-statistic of 0.76) was developed using stepwise selection in multivariable logistical regression models. After corrections of overfitting by validating in 100 bootstrapping samples, the predictive accuracy of the model dropped to 0.71, suggesting at least moderate overfitting. A point-based risk index was developed based on parameter estimates of each predictive factor in the final logistic model. The index has an area under the receiver operating characteristic curve of 0.76. CONCLUSION: The study developed an efficient index with good predictive ability of Self-Neglect. Further external validation and impact studies are necessary before practitioners can apply this index to determine risk of Self-Neglect among other community aging populations. J Am Geriatr Soc 68:809-816, 2020.

  • association between neighborhood cohesion and Self Neglect in chinese american older adults
    Journal of the American Geriatrics Society, 2017
    Co-Authors: Xinqi Dong
    Abstract:

    Objectives: To examine the association between neighborhood cohesion and risk of Self-Neglect in a community-dwelling Chinese-American older population. Setting: Community. Participants: Chinese-American older adults aged 60 and older interviewed from 2011 to 2013 (N = 3,159). Design: Data were drawn from the Population Study of Chinese Elderly, a cross-sectional community-engaged study in the greater Chicago area. Measurements: Self-Neglect was assessed with systematic observations of a participant's personal and home environment. Neighborhood cohesion was measured using six questions. Results: After controlling for potential confounders, greater neighborhood cohesion was significantly associated with lower risk of overall Self-Neglect (odds ratio (OR) = 0.87, 95% confidence interval (CI) = 0.77–0.98) and moderate to severe Self-Neglect (OR = 0.70, 95% CI = 0.58–0.85) but not significantly associated with mild Self-Neglect (OR = 0.94, 95% CI = 0.82–1.09). Regarding the phenotypes of Self-Neglect, greater neighborhood cohesion was significantly associated with lower risk of poor personal hygiene (OR = 0.80, 95% CI = 0.67–0.96) and need for home repair (OR = 0.70, 95% CI = 0.60–0.83) but not significantly for hoarding (OR = 1.04, 95% CI = 0.89–1.21), unsanitary conditions (OR = 0.88, 95% CI = 0.76–1.02), and inadequate utilities (OR = 1.00, 95% CI = 0.77–1.31). Conclusion: This study highlights the association between greater neighborhood cohesion and lower risk of overall Self-Neglect in Chinese-American older adults. Enhancing neighborhood cohesion may enhance elder Self-Neglect prevention and intervention.

  • Elder Self-Neglect: research and practice
    Clinical Interventions in Aging, 2017
    Co-Authors: Xinqi Dong
    Abstract:

    Elder Self-Neglect is a global public health and human rights issue that threatens older people's health and safety. It commonly refers to refusal or failure to provide oneSelf with care and protection in areas of food, water, clothing, hygiene, medication, living environments, and safety precautions. While prevalent, the status of Self-Neglecting individuals remains largely unclear, in particular within community-dwelling populations. By reviewing the epidemiology of elder Self-Neglect (definition, prevalence, risk factors, and consequences) to date, the present paper identifies key research gaps such as methodological inconsistency in case identification and measurement, and study designs that are inadequate to determine risk factors of Self-Neglect. More importantly, in light of the rapidly growing older population, relevant stakeholders (researchers, healthcare providers, social service providers, legal professionals, community organizations, and policymakers) must be prepared for an expected increasing number of Self-Neglect cases and enlarging scope of the problem. Hence, in this article, I present an overview regarding the management issues of elderly Self-Neglect related to the detection, assessment, reporting and referral, and decision-making capacity. Based on the current literature, the paper is aimed to explore the present knowledge and challenges, and how they can pave the way for solutions to Self-Neglect research, practice, and policy.

Denis A. Evans - One of the best experts on this subject based on the ideXlab platform.

  • prevalence of Self Neglect across gender race and socioeconomic status findings from the chicago health and aging project
    Gerontology, 2012
    Co-Authors: Xinqi Dong, Melissa A. Simon, Denis A. Evans
    Abstract:

    Background: Self-Neglect is the behavior of an elderly person that threatens his/her own health and safety, and it is associated with increased morbidity and mortality. However, the scope of the Self-Neglect in the community population remains unclear. We examined the prevalence of Self-Neglect and its specific behaviors of hoarding, hygiene and other environmental hazards in a community-dwelling elderly population. Methods: A population-based cohort study conducted from 2007 to 2010 in a single cycle in a geographically defined community of 4 adjacent neighborhoods in Chicago, Ill., USA. Participant’s personal and home environment was rated on hoarding, personal hygiene, house in need of repair, unsanitary conditions, and inadequate utility. Prevalence estimates were presented across gender, race/ethnicity, education and income levels. Results: There were 4,627 older adults in the cohort. The prevalence of Self-Neglect and specific personal and environmental hazards varied significantly by race/ethnicity and by levels of education and income. For race/ethnicity, black older adults (men 13.2%; women 10.9%) had a significantly higher prevalence of Self-Neglect than white older adults (men 2.4%; women 2.6%). For those with less than high school education, the prevalence of the Self-Neglect was 14.7% in men and 10.9% in women. For those with an annual income of less than USD 15,000, the prevalence of Self-Neglect was 21.7% in men and 15.3% in women. Conclusion: The prevalence of Self-Neglect and specific behaviors of hoarding, poor hygiene, and other environmental hazards are higher among black older adults and among those with lower levels of education and income.

  • elder Self Neglect and hospitalization findings from the chicago health and aging project
    Journal of the American Geriatrics Society, 2012
    Co-Authors: Xinqi Dong, Melissa A. Simon, Denis A. Evans
    Abstract:

    Objectives: To quantify the relation between reported elder Self-Neglect and rate of hospitalization in a community population of older adults. Design: Prospective population-based study. Setting: Geographically defined community in Chicago. Participants: Community dwelling older adults who participated in the Chicago Health and Aging Project. One thousand one hundred sixty-five of the 6,864 participants in the Chicago Health and Aging Project was reported to social services agency for suspected elder Self-Neglect. Measurements: The primary predictor was elder Self-Neglect reported to social services agency. The outcome of interest was the annual rate of hospitalization, obtained from the Centers for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships. Results: The average annual rate of hospitalization was 0.6 ± 1.3 for participants without elder Self-Neglect and 1.8 ± 3.2 for those with reported elder Self-Neglect. After adjusting for sociodemographic and socioeconomic characteristics, medical commorbidities, and cognitive and physical function, older adults who Neglected themselves had significantly higher rate of hospitalization (rate ratio = 1.47, 95% confidence interval = 1.39�1.55). Greater severity of Self-Neglect (mild: standardized parameter estimate (PE) = 0.24, standard error (0.05); moderate: PE = 0.45 (0.03); severe: PE = 0.54, (0.11), all P < .001) was associated with higher annual rates of hospitalization after adjusting for the same confounders. Interaction term analyses suggest that medical conditions, cognitive impairment, and physical disability did not mediate the significant relationship between Self-Neglect and hospitalization. Conclusion: Reported elder Self-Neglect was associated with higher rates of hospitalization in this community population. Greater severity of Self-Neglect was associated with a greater rate of hospitalization.

  • Elder Self‐Neglect and Hospitalization: Findings from the Chicago Health and Aging Project
    Journal of the American Geriatrics Society, 2012
    Co-Authors: Xinqi Dong, Melissa A. Simon, Denis A. Evans
    Abstract:

    Objectives: To quantify the relation between reported elder Self-Neglect and rate of hospitalization in a community population of older adults. Design: Prospective population-based study. Setting: Geographically defined community in Chicago. Participants: Community dwelling older adults who participated in the Chicago Health and Aging Project. One thousand one hundred sixty-five of the 6,864 participants in the Chicago Health and Aging Project was reported to social services agency for suspected elder Self-Neglect. Measurements: The primary predictor was elder Self-Neglect reported to social services agency. The outcome of interest was the annual rate of hospitalization, obtained from the Centers for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships. Results: The average annual rate of hospitalization was 0.6 ± 1.3 for participants without elder Self-Neglect and 1.8 ± 3.2 for those with reported elder Self-Neglect. After adjusting for sociodemographic and socioeconomic characteristics, medical commorbidities, and cognitive and physical function, older adults who Neglected themselves had significantly higher rate of hospitalization (rate ratio = 1.47, 95% confidence interval = 1.39�1.55). Greater severity of Self-Neglect (mild: standardized parameter estimate (PE) = 0.24, standard error (0.05); moderate: PE = 0.45 (0.03); severe: PE = 0.54, (0.11), all P < .001) was associated with higher annual rates of hospitalization after adjusting for the same confounders. Interaction term analyses suggest that medical conditions, cognitive impairment, and physical disability did not mediate the significant relationship between Self-Neglect and hospitalization. Conclusion: Reported elder Self-Neglect was associated with higher rates of hospitalization in this community population. Greater severity of Self-Neglect was associated with a greater rate of hospitalization.

  • association of personality traits with elder Self Neglect in a community dwelling population
    American Journal of Geriatric Psychiatry, 2011
    Co-Authors: Xinqi Dong, Melissa A. Simon, Robert S. Wilson, Todd Beck, Kelly Mckinell, Denis A. Evans
    Abstract:

    Objective: Elder Self-Neglect is an important public health issue. However, little is known about the association between personality traits and risk of elder Self-Neglect among community-dwelling populations. The objectives of this study are as follows: 1) to examine the association of personality traits with elder Self-Neglect and 2) to examine the association of personality traits with elder Self-Neglect severity. Methods: Population-based study conducted from 1993 to 2005 of community-dwelling older adults (N = 9,056) participating in the Chicago Health Aging Project (CHAP). Subsets of the CHAP participants (N = 1,820) were identified for suspected Self-Neglect by social services agency, which assessed the severity. Personality traits assessed included neuroticism, extraversion, rigidity, and information processing. Logistic and linear regressions were used to assess these associations. Results: In the bivariate analyses, personality traits (neuroticism, extraversion, information processing, and rigidity) were significantly associated with increased risk of elder Self-Neglect. However, after adjusting for potential confounders, the above associations were no longer statistically significant. In addition, personality traits were not associated with increased risk of greater Self-Neglect severity. Furthermore, interaction term analyses of personality traits with health and psychosocial factors were not statistically significant with elder Self-Neglect outcomes. Conclusion: Neuroticism, extraversion, rigidity, and information processing were not associated with significantly increased risk of elder Self-Neglect after consideration of potential confounders.

  • a prospective population based study of differences in elder Self Neglect and mortality between black and white older adults
    Journals of Gerontology Series A-biological Sciences and Medical Sciences, 2011
    Co-Authors: Xinqi Dong, Melissa A. Simon, Carlos Mendes F De Leon, Todd Beck, Terry Fulmer, Liesi E Hebert, Paul A Scherr, Denis A. Evans
    Abstract:

    Self-Neglect is a pervasive public health issue across all racial/ethnic groups. There are an estimated 1.2 million older adults who Self-Neglect annually in the United States (1), and data from social services agencies suggest that Self-Neglect report may be rising (2). According to the National Center on Elder Abuse, Self-Neglect is defined “ … as the behavior of an elderly person that threatens his/her own health and safety. Self-Neglect generally manifests itSelf in an older person as a refusal or failure to provide himSelf/herSelf with adequate food, water, clothing, shelter, personal hygiene, medication (when indicated), and safety precautions” (3). After Self-Neglect cases are reported to social services agencies and upon investigation, some are confirmed, whereas others are not. Although Self-Neglect is associated with adverse outcomes, there is little systematic information on racial/ethnic differences. Self-Neglect is classified as a geriatric syndrome (4), a term often used to capture heterogeneous clinical conditions in older persons that do not usually fit into discrete categories of disease classifications. Moreover, Self-Neglect is an important yet vaguely understood public health issue that represents an extremely frail population crossing sociodemographic and socioeconomic strata. Prior studies indicate that Self-Neglect reported to social services agencies is associated with increased morbidity and mortality, particularly among the confirmed cases of Self-Neglect (5–8). In addition, evidence suggests that the reports of Self-Neglect are more common among black than among white older adults (9), as was found in reports from the National Adult Protective Services Agency and case studies (1,10). Yet, the significance associated with these black and white differences remains unclear. Improved understanding of these issues is critical to inform research, education, practice, and policy to provide targeted prevention, screening, and interventions within specific racial/ethnic groups. We are not aware of any population-based studies that have examined the racial/ethnic differences in both reported and confirmed Self-Neglect and its adverse health outcomes. In this report, we build on the existing literature to examine the black and white differences in mortality associated with reported and confirmed Self-Neglect in a large and sociodemographically diverse biracial cohort. Our hypothesis is that black compared with white older adults with reported and confirmed Self-Neglect have significantly greater mortality risk.

Carmel B Dyer - One of the best experts on this subject based on the ideXlab platform.

  • Assessing Capacity in the Setting of Self-Neglect:
    2020
    Co-Authors: Aanand D Naik, Jason Burnett, Sabrina Pickens, Michael E. Debakey, Carmel B Dyer
    Abstract:

    Summary Compared to older adults with disabilities and those who autonomously choose tolive in squalor; Self-Neglect syndrome arises from a predicate state ofvulnerability in frail older adults. This state of vulnerability is characteristicallyassociated with a decline in decision-making capacity regarding the ability to carefor and protect oneSelf. We developed the COMP Screen to evaluate vulnerableolder adults to identify potential gaps in decision-making capacity using ascreening tool. A total of 182 older adults were evaluated and consistent declinesin cognitive ability and decision-making processes were present in thispopulation. However, there were no significant differences between eldersreferred for Self-Neglect and matched older adults. These findings suggest thatdeclines in decision-making processes are not uncommon in vulnerable olderadults but traditional conceptualizations of decision-making capacity may beinadequate for differentiating the capacity for Self care and protection in elderswho Self-Neglect.KeywordsSelf-Neglect; Capacity; Decision-making; Self Care and Protection

  • Exploring Self-Neglect in older adults: preliminary findings of the Self-Neglect severity scale and next steps.
    Journal of the American Geriatrics Society, 2020
    Co-Authors: P Adam Kelly, Carmel B Dyer, Valory N Pavlik, Rachelle S Doody, Gerald J Jogerst
    Abstract:

    Despite the public health implications of Self-Neglect, no tool exists for characterizing this condition. Self-Neglecters often have no caregivers or surrogates to interview regarding the Neglect and are often too cognitively impaired to provide valid Self-reports. In response to this need, researchers from the Consortium for Research in Elder Self-Neglect of Texas (CREST) collaborated with other experts in the field of elder Self-Neglect to design the Self-Neglect Severity Scale (SSS). The SSS assesses three domains of Self-Neglect (hygiene, functioning, and environment) and relies on observational ratings assigned by trained observers. After pilot testing and revision, the SSS was field tested in the homes of subjects who had been reported to and substantiated by Texas Adult Protective Services (APS) as Self-Neglecting and compared with results of subjects recruited from a local geriatric clinic who were reported to APS but had no history of Self-Neglect. The first field test demonstrated that the SSS could distinguish elderly Self-Neglecters from community dwellers who do not Self-Neglect. The SSS exhibited adequate scale reliability (Cronbach alpha) and correlation with case status. Interrater reliability also appeared adequate, although sensitivity and specificity fell below the conventional acceptable range. Future methods are proposed for refining the SSS to improve its use as the benchmark for identifying elder Self-Neglect.

  • medical implications of elder abuse Self Neglect
    Clinics in Geriatric Medicine, 2014
    Co-Authors: Carlos A Reyesortiz, Carmel B Dyer, Jason Burnett, David V Flores, John M Halphen
    Abstract:

    Self-Neglect is the most common report received by Adult Protective Service Agencies. Self-Neglect is associated with multiple medical comorbidities and increased mortality. Comprehensive geriatric assessment coupled with capacity assessment is the best practice for case identification and evaluation. Medical and social interventions are indicated in cases of Self-Neglect. Self-Neglect is a significant public health issue, and policies are needed to address the clinical needs of this vulnerable population.

  • Increasing surveillance and prevention efforts for elder Self-Neglect in clinical settings
    Aging Health, 2012
    Co-Authors: Jason Burnett, David V Flores, John M Halphen, W. Andrew Achenbaum, Leslie Hayes, Ann E Hochschild, Carmel B Dyer
    Abstract:

    Elder Self-Neglect is a growing public health problem characterized by a complex network of biopsychosocial risk factors and predictors. The lack of reliable and valid assessment criteria for identifying elder Self-Neglect during brief clinical visits often results in missed opportunities for reducing or preventing the negative health outcomes commonly associated with this geriatric syndrome. Knowing the most salient risk factors and predictors of Self-Neglect in older patients may help clinicians and other healthcare providers appropriately identify and prevent Self-Neglect and the associated negative health outcomes. This article discusses the salient factors that contribute to elder Self-Neglect and how they can be used to improve clinical surveillance and guide intervention and prevention efforts.

  • elder Self Neglect and abuse and mortality risk in a community dwelling population
    JAMA, 2009
    Co-Authors: Xinqi Dong, Carmel B Dyer, Melissa A. Simon, Carlos Mendes F De Leon, Gregory Paveza, Todd Beck, Terry Fulmer, Liesi E Hebert, Denis A. Evans
    Abstract:

    Context Both elder Self-Neglect and abuse have become increasingly prominent public health issues. The association of either elder Self-Neglect or abuse with mortality remains unclear. Objective To examine the relationship of elder Self-Neglect or abuse reported to social services agencies with all-cause mortality among a community-dwelling elderly population. Design, Setting, and Participants Prospective, population-based cohort study (conducted from 1993 to 2005) of residents living in a geographically defined community of 3 adjacent neighborhoods in Chicago, Illinois, who were participating in the Chicago Health and Aging Project (CHAP; a longitudinal, population-based, epidemiological study of residents aged ≥65 years). A subset of these participants had suspected elder Self-Neglect or abuse reported to social services agencies. Main Outcome Measures Mortality ascertained during follow-up and by use of the National Death Index. Cox proportional hazard models were used to assess independent associations of Self-Neglect or elder abuse reporting with the risk of all-cause mortality using time-varying covariate analyses. Results Of 9318 CHAP participants, 1544 participants were reported for elder Self-Neglect and 113 participants were reported for elder abuse from 1993 to 2005. All CHAP participants were followed up for a median of 6.9 years (interquartile range, 7.4 years), during which 4306 deaths occurred. In multivariable analyses, reported elder Self-Neglect was associated with a significantly increased risk of 1-year mortality (hazard ratio [HR], 5.82; 95% confidence interval [CI], 5.20-6.51). Mortality risk was lower but still elevated after 1 year (HR, 1.88; 95% CI, 1.67-2.14). Reported elder abuse also was associated with significantly increased risk of overall mortality (HR, 1.39; 95% CI, 1.07-1.84). Confirmed elder Self-Neglect or abuse also was associated with mortality. Increased mortality risks associated with either elder Self-Neglect or abuse were not restricted to those with the lowest levels of cognitive or physical function. Conclusion Both elder Self-Neglect and abuse reported to social services agencies were associated with increased risk of mortality.

Melissa A. Simon - One of the best experts on this subject based on the ideXlab platform.

  • ELDER Self-Neglect: IMPLICATIONS FOR HEALTH CARE PROFESSIONALS
    2020
    Co-Authors: Xinqi Dong, Melissa A. Simon
    Abstract:

    Elder Self-Neglect refers to the behaviour of an elderly person that threatens his or her own health and safety. Despite the adverse health outcomes associated with Self-Neglect, the majority of cases go unnoticed by health care professionals. This article discusses the epidemiology of Self-Neglect, associated factors, and its consequences. Even though there are significant gaps in research, enough information is known to guide clinical practice. This article presents the practical approaches a health professional can take when a reasonable suspicion of elder Self-Neglect arises. Public health and interdisciplinary team approaches are needed to manage what will be a growing problem as the number of older adults around the world increases.

  • prevalence of elder Self Neglect in a chicago chinese population the role of cognitive physical and mental health
    Geriatrics & Gerontology International, 2016
    Co-Authors: Xinqi Dong, Melissa A. Simon
    Abstract:

    Aim The present study examined the cognitive, physical and psychological characteristics associated with elder Self-Neglect in a USA Chinese older population. Methods The Population Study of Chinese Elderly in Chicago is a population-based epidemiological study of Chinese older adults in the greater Chicago area. In total, 3159 Chinese older adults aged 60 years and older were interviewed from 2011 to 2013. Personal and home environment was rated on hoarding, personal hygiene, house in need of repair, unsanitary conditions and inadequate utility. Results The prevalence of elder Self-Neglect of all severities was higher among older adults who were with worsening health status, lower cognitive function, lower physical function and more depressive symptoms. Poorer health status (mild Self-Neglect OR 1.20, 95% CI 1.06–1.35; moderate/severe Self-Neglect: OR 1.52, 95% CI 1.30–1.77), lower physical function (activities of daily living moderate/severe Self-Neglect OR 1.09, 95% CI 1.05–1.13; instrumental activities of daily living mild OR 1.04, 95% CI 1.03–1.06; instrumental activities of dailiy living moderate/severe OR 1.06, 95% CI 1.04–1.07), lower cognitive function (mild Self-Neglect OR 1.05, 95% CI 1.03–1.07; moderate/severe Self-Neglect OR 1.07, 95% CI 1.04–1.09) and more depressive symptoms (mild Self-Neglect OR 1.05, 95% CI 1.02–1.07; moderate/severe Self-Neglect OR 1.08, 95% CI 1.06–1.11) were significantly associated with increased risk for elder Self-Neglect of all severities. Conclusion Older adults with lower levels of cognitive, physical, and psychological health were more likely to report elder Self-Neglect and its phenotypes. Future research is required to examine risk/protective factors associated with elder Self-Neglect. Geriatr Gerontol Int 2015; ●●: ●●–●●.

  • association between elder Self Neglect and hospice utilization in a community population
    Archives of Gerontology and Geriatrics, 2013
    Co-Authors: Xinqi Dong, Melissa A. Simon
    Abstract:

    Abstract Elder Self-Neglect is associated with substantial 1-year mortality. However, hospice utilization among those with Self-Neglect remain unclear. The objective of this study is to quantify the prospective relation between Self-Neglect and risk for hospice utilization in a community population of older adults. Prospective population-based study in a geographically defined community in Chicago of older adults who participated in the Chicago Health and Aging Project. Of the 8669 participants in the Chicago Health and Aging Project, a subset of 1438 participants was reported to social services agency for suspected elder Self-Neglect. Outcome of interest was the hospice utilization obtained from the Center for Medicare and Medicaid System. Cox proportional hazard models were used to assess independent association of Self-Neglect with risk of hospice utilization using time-varying covariate analyses. After adjusting for potential confounding factors, elders who Self-Neglect was associated with increased risk for hospice utilization (HR, 2.43, 95% CI, 2.10–2.81). Greater Self-Neglect severity (mild: (HR, 2.12 (1.61–2.79); moderate: (HR, 2.36 (1.95–2.84); severe: (HR, 4.66 (2.98–7.30)) were associated with increased risk for hospice utilization. Interaction term analyses suggest that the significant relationship between Self-Neglect and hospice utilization was not mediated through medical conditions, cognitive impairment and physical disability. Moreover, Self-Neglect was associated with shorter length of stay in hospice (PE, −0.27, SE, 0.12, p p

  • prevalence of Self Neglect across gender race and socioeconomic status findings from the chicago health and aging project
    Gerontology, 2012
    Co-Authors: Xinqi Dong, Melissa A. Simon, Denis A. Evans
    Abstract:

    Background: Self-Neglect is the behavior of an elderly person that threatens his/her own health and safety, and it is associated with increased morbidity and mortality. However, the scope of the Self-Neglect in the community population remains unclear. We examined the prevalence of Self-Neglect and its specific behaviors of hoarding, hygiene and other environmental hazards in a community-dwelling elderly population. Methods: A population-based cohort study conducted from 2007 to 2010 in a single cycle in a geographically defined community of 4 adjacent neighborhoods in Chicago, Ill., USA. Participant’s personal and home environment was rated on hoarding, personal hygiene, house in need of repair, unsanitary conditions, and inadequate utility. Prevalence estimates were presented across gender, race/ethnicity, education and income levels. Results: There were 4,627 older adults in the cohort. The prevalence of Self-Neglect and specific personal and environmental hazards varied significantly by race/ethnicity and by levels of education and income. For race/ethnicity, black older adults (men 13.2%; women 10.9%) had a significantly higher prevalence of Self-Neglect than white older adults (men 2.4%; women 2.6%). For those with less than high school education, the prevalence of the Self-Neglect was 14.7% in men and 10.9% in women. For those with an annual income of less than USD 15,000, the prevalence of Self-Neglect was 21.7% in men and 15.3% in women. Conclusion: The prevalence of Self-Neglect and specific behaviors of hoarding, poor hygiene, and other environmental hazards are higher among black older adults and among those with lower levels of education and income.

  • elder Self Neglect and hospitalization findings from the chicago health and aging project
    Journal of the American Geriatrics Society, 2012
    Co-Authors: Xinqi Dong, Melissa A. Simon, Denis A. Evans
    Abstract:

    Objectives: To quantify the relation between reported elder Self-Neglect and rate of hospitalization in a community population of older adults. Design: Prospective population-based study. Setting: Geographically defined community in Chicago. Participants: Community dwelling older adults who participated in the Chicago Health and Aging Project. One thousand one hundred sixty-five of the 6,864 participants in the Chicago Health and Aging Project was reported to social services agency for suspected elder Self-Neglect. Measurements: The primary predictor was elder Self-Neglect reported to social services agency. The outcome of interest was the annual rate of hospitalization, obtained from the Centers for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships. Results: The average annual rate of hospitalization was 0.6 ± 1.3 for participants without elder Self-Neglect and 1.8 ± 3.2 for those with reported elder Self-Neglect. After adjusting for sociodemographic and socioeconomic characteristics, medical commorbidities, and cognitive and physical function, older adults who Neglected themselves had significantly higher rate of hospitalization (rate ratio = 1.47, 95% confidence interval = 1.39�1.55). Greater severity of Self-Neglect (mild: standardized parameter estimate (PE) = 0.24, standard error (0.05); moderate: PE = 0.45 (0.03); severe: PE = 0.54, (0.11), all P < .001) was associated with higher annual rates of hospitalization after adjusting for the same confounders. Interaction term analyses suggest that medical conditions, cognitive impairment, and physical disability did not mediate the significant relationship between Self-Neglect and hospitalization. Conclusion: Reported elder Self-Neglect was associated with higher rates of hospitalization in this community population. Greater severity of Self-Neglect was associated with a greater rate of hospitalization.

Maria P Pavlou - One of the best experts on this subject based on the ideXlab platform.

  • the abrams geriatric Self Neglect scale introduction validation and psychometric properties
    International Journal of Geriatric Psychiatry, 2018
    Co-Authors: Robert C Abrams, Maria P Pavlou, Carrington M Reid, Cynthia A Lien, Anthony Rosen, Nancy Needell, Joseph P Eimicke, Jeanne A Teresi
    Abstract:

    Objective: Self-Neglect is an imprecisely defined entity with multiple clinical expressions and adverse health consequences, especially in the elderly. However, research has been limited by the absence of a measurement instrument that is both inclusive and specific. Our goal was to establish the psychometric properties of a quantitative instrument, the Abrams Geriatric Self-Neglect Scale (AGSS).

  • The Abrams geriatric Self‐Neglect scale: introduction, validation and psychometric properties
    International Journal of Geriatric Psychiatry, 2017
    Co-Authors: Robert C Abrams, Maria P Pavlou, Cynthia A Lien, Anthony Rosen, Nancy Needell, Joseph P Eimicke, M. Carrington Reid, Jeanne A Teresi
    Abstract:

    Objective: Self-Neglect is an imprecisely defined entity with multiple clinical expressions and adverse health consequences, especially in the elderly. However, research has been limited by the absence of a measurement instrument that is both inclusive and specific. Our goal was to establish the psychometric properties of a quantitative instrument, the Abrams Geriatric Self-Neglect Scale (AGSS).

  • Self Neglect in older adults a primer for clinicians
    Journal of General Internal Medicine, 2008
    Co-Authors: Maria P Pavlou, Mark S Lachs
    Abstract:

    Self-Neglect in older adults is an increasingly prevalent, poorly understood problem, crossing both the medical and social arenas, with public health implications. Although lacking a standardized definition, Self-Neglect is characterized by profound inattention to health and hygiene. In light of the aging demographic, physicians of all specialties will increasingly encounter Self-Neglectors. We outline here practical strategies for the clinician, and suggestions for the researcher. Clinical evaluation should include attention to medical history, cognition, function, social networks, psychiatric screen and environment. The individual’s capacity is often questioned, and interventions are case-based. More research is needed in basic epidemiology and risk factors of the problem, so that targeted interventions may be designed and tested. The debate of whether Self-Neglect is a medical versus societal problem remains unresolved, yet as health sequelae are part of the syndrome, physicians should be part of the solution.

  • could Self Neglect in older adults be a geriatric syndrome
    Journal of the American Geriatrics Society, 2006
    Co-Authors: Maria P Pavlou, Mph Mark S Lachs
    Abstract:

    Self-Neglect in older adults is a complex phenomenon characterized by inattention to health and hygiene, typically stemming from an inability or unwillingness to access potentially remediating services. Some aspects of Self-Neglect clinically resemble geriatric syndromes (e.g., falling, incontinence). The literature on Self-Neglect was comprehensively reviewed and its quality evaluated in the context of considering its candidacy for a geriatric syndrome. MEDLINE (1966–2004) was searched using Self-Neglect as a keyword. Using a “snowball” sampling strategy, associated terms (e.g., Diogenes' syndrome) were combined, selecting relevant papers and frequently cited references, assessing each one using specific criteria. Its candidacy for consideration for a geriatric syndrome was assessed based on the quality of data in four domains: multifactorial etiology, shared risk factors with other geriatric syndromes, association with functional decline, and association with increased mortality. The 54 articles reviewed included 24 case series, 13 theoretical articles, 11 observational studies, and six reviews; these were of highly variable methodological quality. The strongest evidence that Self-Neglect may be a geriatric syndrome includes its often multifactorial etiology, its clear independent association with increased mortality, and the fact that two other geriatric syndromes (cognitive impairment and depression) are risk factors for Self-Neglect. Self-Neglect in older adults is a prevalent problem that appears to have at least some features of a geriatric syndrome. Insofar as the concept of geriatric syndrome has been a useful clinical and research paradigm to create interventions for vulnerable older adults, and no such strategies are available for this vexing and understudied clinical problem, future research is warranted in this area.