Effect of physical frailty on elder mistreatment in a national survey: examining psychological vulnerability, housework involvement, and financial independence as mediators

Objectives: To explore the prevalence of EM in an older Chinese population and examine the mediating role of three psychosocial variables - psychological vulnerability, housework involvement, and financial independence - in the relationship between physical frailty and EM. Design: Cross-sectional analysis. Setting: The data source was the Third Survey on Chinese Women's Social Status (SCSSW), which is a nationwide decennial survey conducted in 2010. Participants: Community-dwelling adults aged 60 and older who participated in SCSSW (N = 3516). Measurements: The past-year prevalence of EM and its seven subtypes, physical frailty, psychological vulnerability, housework involvement, financial independence, and demographic characteristics. Results: The past-year prevalence of EM was 4% among Chinese older adults, with psychological abuse being the most common subtype (3.9%). A higher level of physical frailty had a direct influence on EM. Older adults with higher levels of physical frailty were more likely to have higher levels of psychological vulnerability (anxiety, loneliness, and uselessness) and lower levels of housework involvement, which further correlated with increased risk of EM. Frail Chinese older adults were less likely to have financial independence, which in turn, surprisingly predicted a lower probability of EM. Conclusions: In this nationally representative sample, we provided the first evidence of the prevalence of EM among Chinese older adults and expanded the global understanding of EM by examining the mediating role of three psychosocial variables. Future studies are warranted to corroborate our findings and identify factors contributing to the complex mechanism of EM.