What is the association between self-neglect, depressive symptoms and untreated medical conditions?

J Elder Abuse Negl. 2006;18(4):25-34. doi: 10.1300/J084v18n04_04.


Objective: There have been no studies describing the occurrence of untreated medical condition(s) in elders with depression who self-neglect. This study compares the prevalence of depression as indicated by an abnormal score ( > or = 5) on the Geriatric Depression Scale-Short Form (GDS-SF) between self-neglecters and matched non self-neglecting community-dwelling elders. It also describes the relationship between untreated medical condition(s) associated with self-neglect and abnormal scores on the GDS-SF.

Methods: The two samples consisted of 50 self-neglect cases validated by Adult Protective Services and 50 matched non-self-neglecters recruited from a hospital geriatric unit. The cases and controls were matched on age, gender, ethnicity and socio-economic status when possible. All were assessed in their home. Each participant received a comprehensive geriatric assessment, which included the Geriatric Depression Scale-Short Form, the Mini-Mental State Exam, the Self-Rated Health and Mortality question, and the Physical Performance Test. A laboratory blood analysis was also conducted. Untreated medical condition(s) was determined during the assessment by a geriatric nurse practitioner.

Results: There was a statistically significant difference in the distribution of abnormal GDS-SF scores between the self-neglect (n = 25, 51%) versus the control group (n = 14, 28%; X2 = 5.49, df = 1, p = .019). Self-neglecters with scores indicative of depression were also significantly more likely (56% vs. 21%) to have untreated medical condition(s) compared to self-neglecters scoring normal on the GDS-SF (OR = 4.84, 95% CI = 1.37-17.09).

Conclusion: Clinicians should anticipate untreated medical condition(s) in elderly patients with depressive symptomatology who self-neglect.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Attitude to Health
  • Depression / complications*
  • Depression / mortality
  • Depression / psychology
  • Elder Abuse / mortality*
  • Elder Abuse / psychology
  • Female
  • Humans
  • Male
  • Retrospective Studies
  • Risk Factors
  • Self Care / psychology*
  • Socioeconomic Factors
  • Survival Rate / trends
  • Treatment Refusal / psychology*
  • United States / epidemiology