Prevalence of Elder Abuse and Neglect of Persons with Dementia in Community Settings: A Systematic Review and Meta-Analysis

Introduction: Individuals with dementia are at an elevated risk for abuse and neglect. This study aimed to estimate pooled prevalence rates of elder abuse among community-dwelling individuals with dementia using a meta-analytic approach. Additionally, it explored the heterogeneity associated with prevalence estimates through subgroup analyses. Methods: In line with the Cochrane guidelines, searches were conducted across eight academic online databases, reference lists of eligible studies, and existing systematic reviews. Eligible studies are studies published between January 1990 to March 2023 that report elder abuse among people with dementia in community settings. The final review included 30 eligible studies from eight countries, encompassing a sample of 6,789 dependent/carer dyads. Results: The pooled rate of overall abuse among older adults with dementia is 42.6% [95% CI 0.34-0.51]. Among the various forms of abuse, psychological abuse was most prevalent, occurring in 44.8% of cases [ 95% CI 0.37, 0.52], followed by financial abuse [28.3%, 95% CI 0.03, 0.53], neglect [19.8%, 95%CI 0.09, 0.34], and physical abuse [10%, 95%CI 0.07, 0.13]. Conclusion: The high prevalence of elder abuse highlights the significant vulnerability of individuals with dementia. The highest rate of psychological abuse indicates a particular need to address emotional trauma of people with dementia (PWD), as well as to adopt measures to reduce abusive or neglectful behaviors via caregiver education and support.