Violence against older people in Brazil: associated factors according to the type of aggressor

Santos, Maria Angélica Bezerra dos; Silva, Vanessa de Lima; Gomes, Gabriela Carneiro; Oliveira, André Luiz Sá de; Moreira, Rafael da Silveira

doi:10.1590/1981-22562022025.220186.en

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Original Articles • Rev. bras. geriatr. gerontol. 25 (4) • 2022 • https://doi.org/10.1590/1981-22562022025.220186.en copy

Violence against older people in Brazil: associated factors according to the type of aggressor

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Factors associated with violence against older Brazilians were analyzed according to the type of aggressor. Population-based cross-sectional study with secondary data from the National Health Survey in 2013, totaling 11,697 individuals aged 60 years or older in Brazil. The dependent variable was having suffered violence by a known or unknown aggressor, and the independent variables were divided into blocks (Socioeconomic and demographic; Self-perception and health care; Health service use; Health status/disease and Functioning). The effect of the independent variables on the response variable was expressed by the “Odds Ratio” with a 95% Confidence Interval. Hierarchical models of simple and multiple multinomial logistic regression were performed. In the simple analysis, variables with p-value 0.05 were elective for multiple analysis. A thematic map was constructed according to the spatial distribution of violence, by state. White skin color, 68 years, knowing how to read and write, sleep problems, not feeling pleasure in doing activities and having a physical disability were associated with the unknown aggressor. Poor health, smoking, discrimination in the health service and feeling bad about oneself were associated with the known aggressor. Discrimination by type of illness and little difficulty going, out alone were associated for both aggressors. States with the highest number of cases of violence found were Amapá, Paraná, Mato Grosso, Amazonas and Rio Grande do Norte. Thus, estimating the prevalence of violence against older people, the type of aggressor, as well as associated factors, is essential for identifying and preventing individual, institutional and structural abuse.

Keywords
Violence; Old man; Older people abuse; Aged, 80 and over

BLOCKS	QUESTIONS
Socioeconomic and demographic	Sex? Color or race? Age? Do you live with a spouse or partner? What is the marital status? Can you read and write?
Self-perception and health care	In general, how would you rate your health? Do you currently smoke any tobacco products? In the last three months, did you practice any kind of physical exercise or sport? (do not consider physiotherapy). How often do you usually consume alcoholic beverages?
Use of health service	Have you ever felt discriminated against or treated worse than other people in the health service by a doctor or other health professional for: Lack of money? Social class? Race/Color? Type of occupation? Illness? Religion/belief? Age? Another motive?
State of Health/Illness	In the last 12 months, were you hospitalized for 24 hours or more? Has a doctor or mental health professional (such as a psychiatrist or psychologist) diagnosed you with: -Depression? -Another mental illness, such as schizophrenia, bipolar disorder, psychosis, or OCD (Obsessive Compulsive Disorder)? In the past two weeks, how often did you: -Have you had sleep problems, such as difficulty falling asleep, waking up frequently at night, or sleeping more than usual? -Did you have problems with not feeling rested and ready during the day, feeling tired, without energy? -Did you feel bothered by having little interest or did you not feel pleasure in doing things? -Did you have trouble concentrating on your usual activities? -Have you had eating problems, such as having a lack of appetite or eating a lot more than usual? -Did you feel depressed, “down” or hopeless? -Did you feel bad about yourself, feeling like a failure or feeling like you let your family down? -Did you use any medication to sleep?
Functionality	Do you participate in organized social activities (clubs, community or religious groups, senior living centers, etc.)? Do you drive a car? Do you have a physical disability? Do you have any hearing impairment? Do you have any visual impairment? In general, how difficult is it to go out alone using public transport such as the bus, subway, taxi, car, etc.?

Variables	Unknown		Known		p-value
Variables	OR	95%CI	OR	95%CI	p-value
Block 1: Socioeconomic and Demographic Factors ^a
Color or race					0.010 *
Black	1		1
White	2.53	1.28~4.99†	1.34	0.63~2.86
Yellow and Indigenous	3.50	0.83~14.77	0.08	0.01~0.64†
Brown	1.77	0.88~3.58	1.35	0.63~2.90
Age					0.038*
>68 years	1		1
<68 years	1.68	1.07~2.64†	1.35	0.63~2.90
Can you read and write?					0.001*
No	1
Yes	2.76	1.63~4.70†	1.01	0.61~1.70
Block 2: Self-perception and Health Care Factors ^b
Health assessment					0.020*
Very good or good	1		1
Regular	1.13	0.70~1.83	0.88	0.53~1.44
Very bad or bad	1.21	0.55~2.65	2.39	1.29~4.43†
Do you smoke any tobacco products?					0.008*
I dont smoke	1		1
Yes, daily	1.51	0.76~3.00	2.17	1.21~3.89†
Yes, less than daily	2.63	0.78~8.83	4.09	1.18~14.19†
Block 3: Health Service Use Factors ^c
Discrimination in the health service by a health professional due to:
Disease type?					0.002*
No	1		1
Yes	3.78	1.37~10.48†	3.04	1.35~6.87†
Race/color motive?					0.001*
No	1		1
Yes	3.22	0.75~13.77	0.02	0.00~0.18†
For religion/belief?					0.006*
No	1		1
Yes	0.15	0.02~1.29	6.06	1.63~22.52†
Block 4: Health/Illness Status Factors ^d
In the past two weeks:
Did you have sleep problems?	1		1		0.026*
No	1.64	0.91~2.96	1.93	0.10~3.75
Less than half the days	2.07	0.81~5.32	0.86	0.41~1.81
More than half of the days	1.83	1.01~3.30†	1.70	0.98~2.95
Did you feel bothered by having little interest or did you not feel pleasure in doing things?					0.010*
No	1		1
Less than half the days	0.97	0.47~2.00	1.10	0.51~2.39
More than half of the days	3.43	1.45~8.15†	1.67	0.71~3.89
Almost everyday	0.36	0.14~0.90†	0.75	0.34~1.66
Did you feel bad about yourself, feeling like a failure or feeling like you've let your family down?					<0.001**
No	1		1
Less than half the days	1.16	0.60~2.22	3.87	1.91~7.85†
More than half of the days	2.08	0.59~7.31	0.80	0.25~2.56
Almost everyday	2.61	0.53~12.71	5.14	2.23~11.88†
Block 5: Functionality Factors ^e
Do you have a physical disability?					0.011*
No	1		1
Yes	5.53	1.66~18.45†	0.54	0.18~1.68
Difficulty level to go out alone using transport such as bus, subway, taxi, car, etc?

Not able	1		1		0.004*
Has great difficulty	1.60	0.31~8.19	2.16	0.67~5.97
Has little or no difficulty	6.46	1.66~25.08†	3.13	1.14~8.64†

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[1] Correspondence Maria Angélica Bezerra dos Santos profangellikasantos@gmail.com