Researchers at the Rutgers Institute for Health, Health Care Policy and Aging Research have developed a new assessment tool that could help predict whether older Chinese adults will experience self-neglect.

Self-neglect is a serious threat to older adults’ health and safety and often includes behavior such as failing to provide themselves with adequate food and water, clothing or shelter. Prior research has found the risk of premature death is more than 15 times greater for older adults who experience self-neglect, and they are also more likely to experience other types of elder abuse.

“Having a better understanding of elder self-neglect and the risk factors could allow for earlier intervention and help to improve outcomes and healthy aging,” said Dr. XinQi Dong, MD, MPH, lead researcher and director of the institute.

Using data from the Population Study of Chinese Elderly (PINE) in Chicago, researchers identified factors that are predictive of self-neglect in older Chinese adults and used them to develop a 19-item assessment tool. The results are published online in the journal Aging & Mental Health.

Researchers found predictive factors include more recent immigration to the United States, use of over-the-counter herbal products, as well as a lack of preventive health care and poor family and support. Such factors related to isolation and barriers to health care faced by immigrants are concerning, particularly in the midst of the coronavirus pandemic, Dong noted.

“Even prior to COVID-19, loneliness has been associated with negative health outcomes including self-neglect, depression and suicidal ideation,” Dong said. “These problems will only be exacerbated by social isolation and discrimination that Asian and older adult populations are experiencing during this crisis.”

This study, as the first to look at predictors among older Chinese adults over time, adds to the understanding of self-neglect, and the role of cultural factors, researchers said. The factors identified for older Chinese adults were different than those identified for non-Hispanic black and white older adults in a similar study last year, said first author Bei Wang, MPH.

“Culturally relevant assessment tools and additional research are needed for diverse populations because of the impact of factors such as language, immigration, and systemic disadvantages associated with each population” Wang explained. “Older Chinese adults are an underserved and understudied population, making it even more important to have a tool like this that can accurately predict their individual risk of self-neglect.”

With further studies, the assessment tool could help health care and social service providers estimate older Chinese adults’ risks for self-neglect, researchers said.

The study was supported by the U.S. Administration on Aging.