Association between domestic abuse and violence against older adults and frailty, depression, and nutritional status in an urban Brazilian setting

Objective:
To investigate the association between the risk of violence against older adults and factors such as frailty, depressive symptoms, and nutritional status in a population receiving care in Primary Health Care (PHC).
Methods:
This was an observational, cross-sectional, and quantitative study conducted between June 2023 and March 2024 in the municipalities of Santa Cruz and Macaíba, Rio Grande do Norte, Brazil. The study included 323 older adults (≥ 60 years old) registered in the PHC system. Data collection utilized validated instruments, including the Hurt, Insult, Threaten, Scream - Elder Abuse Screening Test (H-S/EAST) to assess violence risk, the Conflict Tactics Scales Form R (CTS-1) for classifying violence situations, the Edmonton Frailty Scale (EFS) for frailty, the Geriatric Depression Scale (GDS-15) for depressive symptoms, and the Mini Nutritional Assessment (MNA) for nutritional status. Statistical analyses included descriptive statistics, chi-square tests, Mann-Whitney U tests, Spearman correlations, and binary logistic regression.
Results:
Among participants, 46.1% were at risk of violence. Absence of verbal aggression, adequate social support, emotional independence, and better functionality were protective factors against violence. Advanced frailty (OR = 2.43), depressive symptoms (OR = 2.49), and malnutrition (OR = 1.52) were significantly associated with the risk of abuse. Logistic regression identified mood (R² = 0.19) and depressive symptoms (R² = 0.19) as the main predictors of violence.
Conclusion:
A significant association was found between the risk of abuse and multidimensional factors, particularly a history of violent situations, frailty, and depressive symptoms.