Abuse and neglect of older persons in seven cities in seven countries in Europe: a cross-sectional community study.

OBJECTIVES: We aimed to investigate the prevalence rate of abuse (psychological, physical, sexual, financial, neglect) of older persons (AO) in seven cities from seven countries in Europe (Germany, Greece, Italy, Lithuania, Portugal, Spain, Sweden), and to assess factors potentially associated with AO. METHODS: A cross-sectional study was conducted in 2009 (n = 4,467, aged 60-84). Potentially associated factors were grouped into domains (domain 1: age, gender, migration history; domain 2: education, occupation; domain 3: marital status, living situation; domain 4: habitation, income, financial strain). We calculated odds ratios (OR) with their respective 95 % confidence intervals (CI). RESULTS: Psychological AO was the most common form of AO, ranging from 10.4 % (95 % CI 8.1-13.0) in Italy to 29.7 % (95 % CI 26.2-33.5) in Sweden. Second most common form was financial AO, ranging from 1.8 % (95 % CI 0.9-3.2) in Sweden to 7.8 % (95 % CI 5.8-10.1) in Portugal. Less common was physical AO, ranging from 1.0 % (95 % CI 0.4-2.1) in Italy to 4.0 % (95 % CI 2.6-5.8 %) in Sweden. Sexual AO was least common, ranging from 0.3 (95 % CI 0.0-1.1) in Italy and Spain to 1.5 % (95 % CI 0.7-2.8) in Greece. Being from Germany (AOR 3.25, 95 % CI 2.34-4.51), Sweden (OR 3.16, 95 % CI 2.28-4.39) or Lithuania (AOR 2.45, 95 % CI 1.75-3.43) was associated with increased prevalence rates of AO. CONCLUSION: Country of residence of older people is independent from the four assessed domains associated with AO. Life course perspectives on AO are highly needed to get better insight, and to develop and implement prevention strategies targeted at decreasing prevalence rates of AO.

Susceptibility for postmenopausal osteoporosis: interaction between genetic, hormonal and lifestyle factors.

Although previous studies have established the importance of genetic, hormonal and lifestyle factors separately, the integral role of these factors on bone mass in postmenopausal women is still controversial. We examined the association of the collagen 1-alpha-1 gene (COLIA1) and vitamin D receptor gene (VDR) polymorphisms, s-IGF-I, s-25OHD and lifestyle factors with bone mineral density (BMD) in postmenopausal women. We determined anthropometric parameters, lifestyle factors, serum levels of IGF-I and 25OHD, the COLIA1 Sp1 (Mscl) and VDR (Bsml, Taql) polymorphisms by PCR and BMD by dual X-ray absorptiometry in 141 ambulatory postmenopausal Spanish women. There were significant linear correlations between S-25OHD and BMD and between s-IGF-I and BMD. BMD was statistically higher in active subjects. Of the three different polymorphisms, only the COLIA1 Sp1 polymorphism was significantly associated with BMD. In the logistic regression model, the COLIA1 Sp1 polymorphism, S-25OHD, s-IGF-I and physical activity variables were independently associated with osteoporosis. Our study shows that COLIA1 Sp1 polymorphism, S-25OHD and s-IGF-I serum levels and physical activity are independently associated with BMD in postmenopausal Spanish women.