A prospective population-based study of differences in elder self-neglect and mortality between black and white older adults

Xin Qi Dong*, Melissa A. Simon, Terry Fulmer, Carlos F Mendes De Leon, Liesi E. Hebert, Todd Beck, Paul A. Scherr, Denis A. Evans

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


Background: Self-neglect is the behavior of an elderly person that threatens his or her own health and safety, and it is associated with increased morbidity and mortality. Although report of self-neglect is more common among black older adults, the racial/ethnic differences in mortality remain unclear. Methods: The Chicago Healthy Aging Project is a population-based cohort study conducted from 1993 to 2005. A subset of these participants were suspected to self-neglect and were reported to a social services agency. Mortality was ascertained during follow-up and from the National Death Index. Cox proportional hazards models were used to assess the mortality risk. Results: In the total cohort, there were 5,963 black and 3,475 white older adults, and of these, 1,479 were reported for self-neglect (21.7% in black and 5.3% in white older adults). In multivariable analyses with extensive adjustments, the interaction term indicated that impact of self-neglect on mortality was significantly stronger in black than in white older adults (parameter estimate, 0.54, SE, 0.14, p < .001). This difference persisted over time. In race/ethnicity-stratified analyses, at 6 months after report of self-neglect, the hazard ratio for black older adults was 5.00 (95% confidence interval, 4.47-5.59) and for white older adults was 2.75 (95% confidence interval, 2.19-3.44). At 3 years after report, the hazard ratios were 2.61 (95% confidence interval, 2.25-3.04) and 1.47 (95% confidence interval, 1.10-1.96) for black older adults and white older adults, respectively. Conclusions: Future studies are needed to qualify the casual mechanisms between self-neglect and mortality in black and white older adults in order to devise targeted prevention and intervention strategies.

Original languageEnglish (US)
Pages (from-to)695-704
Number of pages10
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume66 A
Issue number6
StatePublished - Jun 2011


  • Health disparity
  • Mortality
  • Population-based study
  • Race/ethnicity
  • Self-neglect

ASJC Scopus subject areas

  • General Medicine


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