Evidence map›Paper›PMID 36695515›Full record

ArticleJournal of the American Geriatrics Society2023

Frailty predicts referral for elder abuse evaluation in a nationwide healthcare system-Results from a case-control study.

Lena K Makaroun, Ann-Marie Rosland, Maria K Mor, Hongwei Zhang, Elijah Lovelace, Tony Rosen, Melissa E Dichter, Carolyn T Thorpe

Open access · bronzeAbstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
4.3field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 5 citations in OpenAlex.

  1. Observational
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 2 countries.

Lena K MakarounVA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.ORCID 0000-0003-4312-1016
Ann-Marie RoslandVA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.ORCID 0000-0002-5809-5861
Maria K MorVA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
Hongwei ZhangVA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
Elijah LovelaceVA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
Tony RosenDepartment of Emergency Medicine, Weill Cornell Medical College/New-York Presbyterian Hospital, New York, New York, USA.ORCID 0000-0001-6638-4121
Melissa E DichterVA Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, USA.ORCID 0000-0003-4579-1400
Carolyn T ThorpeVA Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.ORCID 0000-0002-5970-8359
University of Pittsburgh · USVA Pittsburgh Healthcare System · USNewYork–Presbyterian Hospital · USPhiladelphia VA Medical Center · USUniversity of North Carolina at Chapel Hill · US

Funding

VARIABILITY, STABILITY & SMOOTHNESS OF WALKINGP30AG024827 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Caterina Rosano · 2004 to 2026
$28.6M
Identifying Injury Patterns and Forensic Biomarkers Diagnostic of Physical Elder AbuseK76AG054866 · NIA · WEILL MEDICAL COLL OF CORNELL UNIV · PI ROSEN, ANTHONY · 2016 to 2021
$1.1M
Identifying Risk and Improving Care for Elder Abuse among VeteransIK2HX003330 · VA · VETERANS HEALTH ADMINISTRATION · PI Lena Makaroun · 2022 to 2026
–
HSRD VA IK2 HX003330HSRD VA SDR 02-237NIA NIH HHS K76 AG054866NIA NIH HHS P30 AG024827
6 · The paper itself

Abstract

backgroundElder abuse (EA) is common and has devastating health impacts. Frailty may increase susceptibility to and consequences of EA for older adults, making healthcare system detection more likely, but this relationship has been difficult to study. We examined the association between a recently validated frailty index and referral to social work (SW) for EA evaluation in the Veterans Administration (VA) healthcare system.

methodsWe conducted a case-control study of veterans aged ≥60 years evaluated by SW for suspected EA between 2010 and 2018 (n = 14,723) and controls receiving VA primary care services in the same 60-day window (n = 58,369). We used VA and Medicare claims data to measure frailty (VA Frailty Index) and comorbidity burden (the Elixhauser Comorbidity Index) in the 2 years prior to the index. We used adjusted logistic regression models to examine the association of frailty or comorbidity burden with referral to SW for EA evaluation. We used Akaike Information Criterion (AIC) values to evaluate model fit and likelihood ratio (LR) tests to assess the statistical significance of including frailty and comorbidity in the same model.

resultsThe sample (n = 73,092) had a mean age 72 years; 14% were Black, and 6% were Hispanic. More cases (67%) than controls (36%) were frail. LR tests comparing the nested models were highly significant (p < 0.001), and AIC values indicated superior model fit when including both frailty and comorbidity in the same model. In a model adjusting for comorbidity and all covariates, pre-frailty (aOR vs. robust 1.7; 95% CI 1.5-1.8) and frailty (aOR vs. robust 3.6; 95% CI 3.3-3.9) were independently associated with referral for EA evaluation.

conclusionsA claims-based measure of frailty predicted referral to SW for EA evaluation in a national healthcare system, independent of comorbidity burden. Electronic health record measures of frailty may facilitate EA risk assessment and detection for this important but under-recognized phenomenon.

Indexed as

Elder AbuseFrailtyAgedCase-Control StudiesDelivery of Health CareFrail ElderlyHumansMedicareUnited Stateselder abusefrailtyveterans

Identifiers

PMID36695515
PMCPMC10258119
OpenAlexW4317935873

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.