Perceived Stress and Elder Abuse: A Population-Based Study of Adult Protective Services Cases in Chicago.

Objectives: To characterize the relationship between perceived stress and Adult Protective Services (APS) elder abuse cases in a population-based sample.

Design: Cross-sectional.

Setting: Chicago.

Participants: community-dwelling, older adults (N = 8,558; mean age 74 ± 7, 62% female, 64% African American).

Measurements: Perceived Stress Scale (PSS), APS database linkage.

Results: Bivariate and adjusted analyses showed that perceived stress was significantly higher in APS clients than in participants without any APS interaction for various subtypes of abuse (e.g., abuse from a perpetrator and self-neglect). This relationship was strongest for those with a confirmed history of abuse from a perpetrator, with a medium-large effect size (t = -5.8, P < .001, Cohen D = -0.6). Those in the highest stress tertile had a likelihood of having confirmed history of abuse from a perpetrator that was nearly three times as great as that of those in lower stress tertiles (odds ratio = 2.7, 95% confidence interval = 1.2-6.2). Analyses of individual PSS items revealed a robust relationship between distress items and APS involvement. Items reflecting coping were inconsistently associated with elder abuse.

Conclusion: Clients of APS have higher levels of perceived stress, and abuse from a perpetrator strengthens this relationship. Therefore, victims of abuse from a perpetrator may be at the highest risk of stress-related consequences and should be targeted for intervention efforts that enhance empowerment and effective coping strategies.