1 This study used data from the Japan Gerontological Evaluation Study (JAGES). This survey was conducted by the Nihon Fukushi University Center for Well-being and Society as one of their research projects, and supported by a grant of Strategic Research Foundation Grant-aided Project for Private Universities from Ministry of Education, Culture, Sport, Science, and Technology, Japan (MEXT), and Health and Labour Sciences Research Grant (Comprehensive Research on Aging and Health) “Development of a Benchmark System for Comprehensive Policy Evaluation of Long-term Care Insurance” (H22-Choju-Shitei-008) Study Group Self-Reported Physical, Psychological and Financial Mistreatment among Community-Dwelling Older Adults in Japan Kayo Suzuki 1, Megumi Kano 2, Jimpei Misawa 3, Kayako Sakisaka 4, Etsuko Yuhara 1, and Katsunori Kondo 1 11 th IFA Conference, May 31, 2012 Contact: 1.Center for Well-Being and Society, Nihon Fukushi University, 2.WHO Centre for Health Development 3.College of Sociology, Rikkyo University 4.Faculty of Policy Studies, Chuo University, 5.Faculty of Social Welfare, Nihon Fukushi University

Background physical %; psychological %; financial % (Podnieks et al. 1990; Ogg & Bennet 1992; McCeadie 1999; Laumann et al. 2008; Acierno et al. 2010; Kissal & BeSEr 2011; Kskinoglu et al. 2007) 2 Risk conditions  Female; older  Low SES  Family structure  Poor interpersonal relationships  Declined physical, mental, and cognitive conditions  History of abuse  Focus of this study: community social capital (Cupitt, 1997; Garre-Olmo et al. 2009; Keskinoglu et al. 2007; Kissal & BeSEr 2011; Pillemer & Finkelhor 1988; Lachs et al., 1997; Swagerty, Takahashi, & Evans 1999; XinQi et al. 2008) Demographic and cultural changes in Japan Prevalence of abuse in the world (community-dwelling elderly)

3 Purposes of the Study  Abuse can occur to the elderly not under the long-term care Declining cognitive and physical function  higher risk 1.Reporting the prevalence of physical, psychological, and financial abuse among community-dwelling elderly in Japan 2.Describing the demographic, socioeconomic, and health characteristics of the abused 3.Estimating the relevant factors for the incidence of abuse

research fields collaborating research institutes Questionnaires mailed to 169,215 elderly in Response from 112,123 (66.3 ％ ) National survey for the community-dwelling elderly not under the national long- term care (aged 65+) 14,909 sample for the analysis of abuse: 6,773 male & 8,139 female 55% y.o & 45% Data: JAGES

5 Questions on abuse in JAGES Have you received the following treatment in the previous year? (1)Physical violence such as punching, kicking, throwing things, and confining—[physical abuse] (2) Derogatory acts such as using abusive language, making sarcastic comments, and ignoring for a long time —[psychological abuse] 1. Often 2. Sometimes 3. Once or twice 4. never (3) Is there anyone (including your family members) who embezzles your savings or pension without your consent? —[financial abuse] 1. resident family 2. non-resident family 3. neighbors/acquaintances 4. other 5. unknown  “Abuse” (esp. psychological abuse) is broadly defined  Perpetrators are not limited to resident family members

6 Prevalence of abuse and non-response (n=14,909) 16.6% experienced at least one type of abuse 9.6% did not respond to at least one question on abuse = suspected cases? 191 (1.3%) 2,145 (14.5%) 382 (2.6%)

The abused has lower physical capacity and poorer physical, mental & cognitive health 7 (%)  Similar gaps were found for self-rated health and loss of memory

Abuse is more common among female, younger, divorced, and those with lower SES 8 (%) Caution needed: the elderly needing LTC were not covered in this survey

Having little social interaction/support is another risk condition 9 (%) Not providing nor receiving emotional & instrumental support

Multivariate analysis p<.05 for all types p<.05 for specific type(s) n.s. Odds Ratios for the Experience of Abuse in the Previous Year (Logistic Regression)

11 Findings When broadly defined, 16.6% of the community-dwelling, mostly ADL-independent elderly in Japan experienced abuse in the previous year –Requires more contextual information Most findings from past studies on health, SES, and social support were confirmed  Different & new findings -Education and family structure…n.s. -Widowhood… risk of abuse ↓ -Lack of interaction with neighbors…psychological abuse ↑

12 Conclusions In Japan, not a few community-dwelling, ADL- independent elderly experience mistreatment Neighbors as a potential means of prevention Suggestions for future research –Total incidence of abuse for both ADL-indep./dep. elderly –Cross-national comparative studies –Type-specific risk and protective conditions  Close monitoring of the different types of elder abuse in the community and evaluation of elder abuse prevention programs are critical to promote safe and healthy ageing societies.