Epidemiology of homicide in community-dwelling older adults: a systematic review and meta-analysis

Background: Empirical research investigating older adult homicide is sparse and rarely accumulated for greater insights. This systematic review and meta-analysis quantifies the prevalence and characteristics of homicide victimization among older adults (65 years and older) compared with younger adults (18–64 years). Method: We searched Cumulative Index to Nursing and Allied Health Literature, Cochrane, Criminal Justice Abstracts, EMBASE, MEDLINE, ProQuest, PsycINFO, Scopus, and Web of Science for studies published before December 31, 2018 (International Prospective Register of Systematic Reviews registration: CRD42017054536). Included were English-language, original, peer-reviewed studies describing the homicide of older adults. Excluded were studies not meeting age criteria, residence as an institution, or with insufficient outcome variables. The review included 39 studies; 17 were included in the meta-analysis. Data were extracted via open access or from study authors. Heterogeneity was assessed through study-level random effects estimates. Results: Pooled homicide rates per 100,000 population were 2.02 (95% CI [1.23, 3.33]) for older adults (n = 35,325) and 3.98 (95% CI [2.42, 6.53]) for younger adults (n = 607,224; rate ratio =.51, 95% CI [0.37, 0.70], p <.001). Proportion estimates for older adults: victim female 46.3%, location home 71.4%, offender familiar 25.2%, compared to stranger, 24.2%, motive argument 36.1%, compared to felony 30.8%, and weapon firearm 24.5%. Older adults were significantly different to younger adult victims (p = <.001) for female (OR = 2.5, 95% CI [2.02, 3.10]), home (3.87, 95% CI [3.45, 4.35]), stranger (1.81, 95% CI [1.66, 1.98]), argument (0.33, 95% CI [0.28, 0.39]), felony (2.78, 95% CI [2.58, 2.99]), and firearm (0.38, 95% CI [0.36, 0.40]). Conclusions: Homicide against older adults differs from younger adults and warrants specific research and tailored prevention strategies.