In this interview, Adriana Lopes Elias discusses the study’s objectives, methodology, and main findings, highlighting how social interactions, social support, and quality of life can help reduce the risk of violence against older adults and inform prevention strategies.
How did the idea for this study arise, and what question did it seek to answer?
The study titled “Risk of Violence Among Older Adults: The Role of Social Interactions, Social Support, and Quality of Life in the EpiFloripa Idoso Longitudinal Study” stems from a central concern: how to understand and address violence against older adults beyond visible incidents, taking into account the social and relational contexts in which it occurs. When we shift our focus from violence itself to the conditions under which it occurs, we realize that we are dealing with a complex phenomenon—often overlooked or underreported—but deeply intertwined with living conditions, social relationships, and the support available throughout the aging process. Paradoxically, this complexity still eludes most studies, which tend to analyze these factors in isolation or through cross-sectional snapshots, thereby limiting our understanding of how they interact over time. Thus, in this context, we sought to determine whether older adults with greater social interaction, a greater perception of social support, and a better quality of life are at lower risk of violence over time. Our goal was to fill this gap by analyzing these associations from a longitudinal perspective. To do so, we used data from the EpiFloripa Idoso study, a population-based cohort that followed older adults aged 60 and older over nearly a decade. We used three waves of this study, which took place in the city of Florianópolis, the capital of Santa Catarina. The baseline wave took place in 2009–2010, with 1,702 participants interviewed. The second wave occurred in 2013 and 2014, with 1,197 participants. The third wave took place in 2017–2019, with 1,335 participants interviewed. The EpiFloripa Idoso study is conducted by the Department of Public Health at the Federal University of Santa Catarina.
How was the study conducted, and which indicators were analyzed?
The study outcome was the risk of violence, which was assessed in waves 2 and 3 using the Hwalek-Sengstock Elder Abuse Screening Test, known as the H-S/East—a tool that has been validated in Brazil for some time. The study variables included social interaction factors, such as internet use, paid work, and participation in social and religious groups, as well as social support and quality of life. Quality of life was analyzed across two dimensions: control and autonomy—which relate to decision-making abilities and independence—and self-actualization and pleasure—which are associated with well-being and life satisfaction. All of these variables were measured using instruments that have already been validated in Brazil.
What were the main findings?
Since this is longitudinal data, we used generalized estimating equation (GEE) models, adjusted for sociodemographic variables such as sex, age, education level, and income. The GEE is an approach that accounts for the correlation between repeated measurements from the same individuals, allowing for the estimation of more robust associations over time. Therefore, this was the most appropriate approach for our study.
The study’s results indicated that the risk of violence among older adults was high, although it decreased over time, falling from 31.4% in wave two to 22.3% in wave three; however, it remained at significant levels when compared to other national and international findings. This risk was more prevalent and occurred more frequently among women and people in more vulnerable socioeconomic conditions, highlighting the persistence of social inequalities in the aging process.
Which factors proved to be most important in reducing the risk of violence?
However, the most relevant aspects of the study lie in the associated protective factors. Thus, with regard to social interactions, participation in groups and paid work were very consistently associated with a lower incidence of violence. Internet use—a relatively recent focus in studies on violence against older adults—also showed a protective trend, with a lower incidence of the outcome among users in some of the analyses, even though the association was not statistically significant after adjustment, he noted. This finding suggested that new forms of social interaction, such as digital inclusion, may play an increasing role in protection as people age. Social support, on the other hand, showed a much more pronounced protective effect, indicating that perceived social support in everyday relationships can significantly reduce vulnerability. But the most significant finding among the factors analyzed was quality of life—especially in the dimensions of control and autonomy—which showed the strongest association with a reduced risk of violence, suggesting a highly significant protective effect even compared to the other associations. These results show that violence cannot be understood merely as an isolated individual event, but rather as a phenomenon that emerges from relationships, living conditions, and the place a person occupies in society.
What insights do these findings offer for public policy and care for the elderly population?
By examining the interplay of these dimensions through a longitudinal analysis, the study helps demonstrate that strengthening social networks, support, and quality of life not only promotes well-being but also directly contributes to the prevention of violence. These findings reinforce the need for intersectoral strategies and primary health care initiatives that consider the social determinants of aging as a central pillar of the care process and of healthier aging.