Regular Research Article| Volume 29, ISSUE 9, P930-940, September 2021

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Impact of Historical Intimate Partner Violence on Wellbeing and Risk for Elder Abuse in Older Women

Published:December 28, 2020DOI:


      • What is the primary question addressed by this study? In what ways do women continue to be affected by past intimate partner violence victimisation in late life?
      • What is the main finding of this study? Older women who have survived intimate partner violence experience poorer psychological health, high risk for incident depression, and greater vulnerability to elder abuse even many years after the violence has ended.
      • What is the meaning of the finding? Older survivors of intimate partner violence are at high risk for psychological ill-being and renewed victimisation, indicating the importance of close clinical monitoring and ongoing support service provision as they age.



      To assess the psychological impacts and risk for elder abuse associated with historical intimate partner violence (IPV) in older women.


      Prospective cohort study


      All Australian states and territories.


      A total of 12,259 women aged 70–75 years at baseline participating in the Australian Longitudinal Study of Women's Health.


      Women were asked at baseline whether they had ever been in a violent relationship with a partner, and completed a comprehensive survey about their physical and psychological health every 3 years (15 years follow-up) including the Short Form-36 Mental Health subscale (SF-MH) and Vulnerability to Abuse Screening Scale (VASS). Linear mixed effects modelling with maximum likelihood estimation assessed the impact of IPV over time on the SF-MH and VASS. Risk for incident depression and experiencing physical or sexual violence over follow-up was examined using logistic regression models.


      The 782 (6.4%) women who reported historical IPV recorded significantly poorer psychological wellbeing at all timepoints compared to those who did not report historical IPV, and were at higher risk for incident depression over follow up (adjusted odds ratio [aOR] = 1.36, 95% confidence interval [CI]:1.11–1.67). There was no significant relationship between historical IPV and self-reported exposure to physical or sexual violence in late life (aOR = 0.87, 95%CI: 0.53–1.43), but women who reported historical IPV recorded higher rates of vulnerability to abuse on the VASS.


      Women who have experienced a violent relationship continue to experience negative effects into older age, highlighting the importance of clinical monitoring and ongoing support for survivors as they age.

      Key Words

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        • Devries KM
        • Mak JY
        • Garcia-Moreno C
        • et al.
        The global prevalence of intimate partner violence against women.
        Science. 2013; 340: 1527-1528
        • Krug EG
        • Mercy JA
        • Dahlberg LL
        • et al.
        The world report on violence and health.
        Lancet. 2002; 360: 1083-1088
        • Vos T
        • Astbury J
        • Piers LS
        • et al.
        Measuring the impact of intimate partner violence on the health of women in Victoria, Australia.
        Bull World Health Organ. 2006; 84: 739-744
        • Campbell JC
        Health consequences of intimate partner violence.
        Lancet. 2002; 359: 1331-1336
        • Clark CJ
        • Alonso A
        • Everson-Rose SA
        • et al.
        Intimate partner violence in late adolescence and young adulthood and subsequent cardiovascular risk in adulthood.
        Prev Med. 2016; 87: 132-137
        • Pathak N
        • Dhairyawan R
        • Tariq S
        The experience of intimate partner violence among older women: a narrative review.
        Maturitas. 2018; : 48-59
        • Cations M
        • Keage H
        • Laver K
        • et al.
        Intimate partner violence and risk for mortality and incident dementia in older women.
        J Interpers Violence. 2020; (In press)
        • Loxton D
        • Dolja-Gore X
        • Anderson AE
        • et al.
        Intimate partner violence adversely impacts health over 16 years and across generations: a longitudinal cohort study.
        PLoS One. 2017; 12e0178138
        • Lagdon S
        • Armour C
        • Stringer M
        Adult experience of mental health outcomes as a result of intimate partner violence victimisation: a systematic review.
        Eur J Psychotraumatol. 2014; 5: 247-294
        • Tan M
        • O'Doherty L
        • Gilchrist G
        • et al.
        Psychological therapies for women who experience intimate partner violence.
        Cochrane Database Syst Rev. 2018; 2018: 1-42
        • Woods SJ
        Intimate partner violence and post-traumatic stress disorder symptoms in women: what we know and need to know.
        J Interpers Violence. 2005; 20: 394-402
        • Loxton D
        • Schofield M
        • Hussain R
        Psychological health in midlife among women who have ever lived with a violent partner or spouse.
        J Interpers Violence. 2006; 21: 1092-1107
        • Devries KM
        • Mak JY
        • Bacchus LJ
        • et al.
        Intimate partner violence and incident depressive symptoms and suicide attempts: a systematic review of longitudinal studies.
        PLoS Med. 2013; 10
        • Zlotnick C
        • Johnson DM
        • Kohn R
        Intimate partner violence and long-term psychosocial functioning in a national sample of american women.
        J Interpers Violence. 2006; 21: 262-275
        • Leiner AS
        • Compton MT
        • Houry D
        • et al.
        Intimate partner violence, psychological distress, and suicidality: a path model using data from African American women seeking care in an urbanemergency department.
        J Fam Violence. 2008; 23: 473-481
        • Zink T
        • Jacobson CJ
        • Pabst S
        • et al.
        A lifetime of intimate partner violence: coping strategies of older women.
        J Interpers Violence. 2006; 21: 634-651
        • Yon Y
        • Mikton CR
        • Gassoumis ZD
        • et al.
        Elder abuse prevalence in community settings: a systematic review and meta-analysis.
        Lancet Glob Health. 2017; 5: e147-e156
        • Yunus RM
        • Hairi NN
        • Choo WY
        Consequences of elder abuse and neglect: a systematic review of observational studies.
        Trauma Violence Abuse. 2019; 20: 197-213
        • Capaldi DM
        • Knoble NB
        • Shortt JW
        • et al.
        A systematic review of risk factors for intimate partner violence.
        Partn Abuse. 2012; 3: 231-280
        • Kuijpers KF
        • van der Knaap LM
        • Winkel FW
        Risk of revictimization of intimate partner violence: the role of attachment, anger and violent behavior of the victim.
        J Fam Violence. 2012; 27: 33-44
        • Buchbinder E
        • Winterstein T
        Like a wounded Bird”: older battered women's life experiences with intimate violence.
        J Elder Abuse Negl. 2003; 15: 23-44
        • Pillemer K
        • Burnes D
        • Riffin C
        • et al.
        Elder abuse: global situation, risk factors, and prevention strategies.
        Gerontologist. 2016; 56: S194-S205
        • Howells K
        • Hollin CR
        Clinical approaches to violence.
        Chichester: Wiley. 1989;
        • Lee C
        • Dobson AJ
        • Brown WJ
        • et al.
        Cohort profile: the Australian longitudinal study on women's health.
        Int J Epidemiol. 2005; 34: 987-991
        • Dobson AJ
        • Hockey R
        • Brown WJ
        • et al.
        Cohort profile update: Australian longitudinal study on women's health.
        Int J Epidemiol. 2015; 44: 1547-1548
        • Ware Jr, JE
        • Sherbourne CD
        The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection.
        Med Care. 1992; 12: 473-483
        • McHorney CA
        • Ware JE
        • Lu JFR
        • et al.
        The MOS 36-Item Short-Form Health Survey (SF-36): tests of data quality, scaling assumptions, and reliability across diverse patient groups.
        Med Care. 1994; 32: 40-66
        • Barsky AJ
        • Weinstein MC
        Performance of a five-item mental health screening test.
        Med Care. 1991; 29: 169-176
        • Goldberg D
        • Bridges K
        • Duncan-Jones P
        • et al.
        Detecting anxiety and depression in general medical settings.
        Br Med J. 1988; 297: 897-899
        • Schofield MJ
        • Mishra GD
        Three year health outcomes among older Omen at risk of elder abuse: women's health Australia.
        Qual Life Res. 2004; 13: 1043-1052
        • Schofield MJ
        • Reynolds R
        • Mishra GD
        • et al.
        Screening for vulnerability to abuse among older women: women's health Australia study.
        J Appl Gerontol. 2002; 21: 24-39
        • Schofield MJ
        • Mishra GD
        Validity of self-report screening scale for elder abuse: Women's Health Australia study.
        Gerontologist. 2003; 43: 110-120
        • Australian Bureau of Statistics
        Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA) 1996, Australia [Internet].
        Australian Bureau of Statistics, 1996 (Available from:)
        • Koenig HG
        • Westlund RE
        • George LK
        • et al.
        Abbreviating the Duke Social Support Index for use in chronically ill elderly individuals.
        Psychosomatics. 1993; 34: 61-69
        • SAS Institute
        SAS Statistical Software.
        SAS Institute Inc, Cary, NC2003
        • Singer JD
        • Willett JB
        • Willett JB
        Applied longitudinal data analysis: Modeling change and event occurrence.
        Oxford University Press, 2003
        • Steptoe A
        • Deaton A
        • Stone AA
        Psychological wellbeing, health and ageing.
        Lancet. 2015; 385: 640-648
        • Cations M
        • Laver KE
        • Walker R
        • et al.
        The case for trauma-informed aged care.
        Int J Geriatr Psychiatry. 2020; 35: 425-429
        • Ryff CD
        Psychological well-being revisited: advances in the science and practice of Eudaimonia.
        Psychother Psychosom. 2014; 83: 10-28
        • Jivraj S
        • Nazroo J
        • Vanhoutte B
        • Chandola T
        Aging and subjective well-being in later life.
        J Gerontol Ser B. 2014; 69: 930-941
        • Douma L
        • Steverink N
        • Hutter I
        • et al.
        Exploring subjective well-being in older age by using participant-generated Word clouds.
        Gerontologist. 2017; 57: 229-239
        • Kivnick HQ
        • Driessen MC
        • Santavasy C
        • et al.
        “Who's been putting socks in my drawer?” Narrative case study of an elder role model.
        Gerontologist. 2020; 60: 831-840
        • Brozowski K
        • Hall DR
        Aging and risk: physical and sexual abuse of elders in Canada.
        J Interpers Violence. 2010; 25: 1183-1199
        • Acierno R
        • Hernandez MA
        • Amstadter AB
        • et al.
        Prevalence and correlates of emotional, physical, sexual, and financial abuse and potential neglect in the United States: The National Elder Mistreatment Study.
        Am J Public Health. 2010; 100: 292-297
        • Fulmer T
        • Paveza G
        • VandeWeerd C
        • et al.
        Dyadic vulnerability and risk profiling for elder neglect.
        Gerontologist. 2005; 45: 525-534
        • Johannesen M
        • LoGiudice D
        Elder abuse: a systematic review of risk factors in community-dwelling elders.
        Age Ageing. 2013; 42: 292-298
        • Fulmer T
        • Guadagno L
        • Bitondo Dyer C
        • et al.
        Progress in elder abuse screening and assessment instruments.
        J Am Geriatr Soc. 2004; 52: 297-304
        • Burnett J
        • Achenbaum WA
        • Murphy KP
        Prevention and early identification of elder abuse.
        Clin Geriatr Med. 2014; 30: 743-759
        • Loxton D
        • Townsend N
        • Cavenagh D
        • et al.
        Measuring domestic violence in longitudinal research.
        Research Centre for Generational Health and Ageing, 2017
        • Sprauge S
        • Madden K
        • Simunovic N
        • et al.
        Barriers to screening for intimate partner violence.
        Women Health. 2012; 52: 587-605
        • Thompson RS
        • Bonomi AE
        • Anderson M
        • et al.
        Intimate partner violence: prevalence, types, and chronicity in adult women.
        Am J Prev Med. 2006; 30: 447-457
        • Allan CE
        • Valkanova V
        • Ebmeier KP
        Depression in older people is underdiagnosed.
        Practitioner. 2014; 258: 19-22
        • Sjöberg L
        • Karlsson B
        • Atti A-R
        • et al.
        Prevalence of depression: comparisons of different depression definitions in population-based samples of older adults.
        J Affect Disord. 2017; 221: 123-131
        • Pickering CEZ
        • Rempusheski VF
        Examining barriers to self-reporting of elder physical abuse in community-dwelling older adults.
        Geriatr Nur (Lond). 2014; 35: 120-125