Frailty increases the likelihood of elder abuse - a systematic literature review; and, A cross-sectional study exploring frailty in older people and the possible inter-relationship with early adverse childhood experiences

Abstract

This thesis aimed to review abuse across the lifespan of an individual, from childhood to older age and how frailty may be both a consequence and a predictor of abuse. The thesis is split into two chapters. The first chapter is a systematic literature review assessing whether frailty is associated with an increased incidence of elder abuse and neglect (EAN). The review included nine studies which provide evidence that frailty may lead to an increased incidence of elder abuse and neglect. Furthermore, it reviews other factors and perpetrator characteristics that may also lead to elder abuse and neglect. Recommendations comprise using longitudinal studies to establish internationally recognised definitions and measures for both frailty and EAN, and the development of evidence-based interventions for people who are older. The second chapter is an empirical study exploring the potential link between adverse childhood experiences (ACEs) and an increased level of frailty in people who are older. A cross-sectional questionnaire design was completed in an NHS setting. Correlation and multiple hierarchical regression analyses were performed. Although there was no association reported between ACEs and frailty, both an increased number of social connections and a positive perception of self were negatively correlated with frailty. Recommendations suggest creation of preventative measures for frailty that incorporate both physical and social interventions, within the context of recent social distancing measures imposed by COVID-19.