Development of a risk assessment model for elder abuse vulnerability among ethnic minority older adults in Hunan, China: a cross-sectional study.

backgroundElder abuse is a significant public health issue, particularly among those from ethnic minorities who often face unique cultural and social challenges that may exacerbate their vulnerability. However, research on elder abuse in this population remains limited. This study aimed to explore the prevalence of vulnerability to abuse among older ethnic minorities in China and to develop a risk assessment model to inform the development of prevention strategies in this population.

methodsFrom February to September 2024, a cross-sectional study was employed to survey 314 older adults from ethnic minorities in Chenzhou, Yongzhou, and Jishou, in Hunan Province of China. The questionnaire included the Vulnerability to Abuse Screening Scale (VASS), the UCLA Loneliness Scale-8 (ULS-8), and the Patient Health Questionnaire-9 (PHQ-9). Statistical analyses were performed using the chi-square test and logistic regression.

resultsThe overall prevalence of self-reported elder abuse risk among older ethnic minorities in China was 58.92%, with the main types being psychological abuse (34.08%), physical abuse (29.94%), neglect (28.34%), and financial exploitation (13.06%). Loneliness and depressive symptoms were identified as risk factors for elder abuse vulnerability (odds ratio [OR] = 1.098 and 1.101, respectively), whereas living in rural areas and receiving community support were identified as protective factors (OR = 0.565 and 0.520, respectively). The risk assessment model was developed as follows: logit(p) = - 1.154 - 0.571×living in rural areas - 0.653× community support services + 0.094×loneliness + 0.096×depressive symptoms. The area under the receiver operating characteristic (ROC) curve of the model was 0.744, with a sensitivity of 0.568 and specificity of 0.860. The Hosmer-Lemeshow goodness-of-fit test showed a P value of 0.383.

conclusionsThe prevalence of self-reported elder abuse risk among older ethnic minorities in China is relatively high and is associated with living in rural areas, receiving community support services, loneliness, and depressive symptoms. The prediction model developed in this study has satisfactory discriminative efficacy and holds certain social application value. These findings inform policymakers and service providers to promote community support services, integrate mental health interventions, and improve older adults' rights protection networks in ethnic minorities to reduce the vulnerability to abuse. CONTRIBUTIONS TO THE LITERATURE: • The prevalence of self-reported elder abuse risk among ethnic minority older adults in China is relatively high, reaching an overall rate of 58.92%. • Loneliness, depressive symptoms, living in rural areas and receiving community support were associated with self-reported elder abuse risk. • Enhancing community support, especially in rural areas, alleviating loneliness, and reducing depressive symptoms may reduce vulnerability to abuse and improve well-being. CLINICAL TRIAL NUMBER: Not applicable.