Highlights & Basics
- Abuse of older adults is a common and increasing worldwide phenomenon as populations live longer.
- Many different forms of abuse exist, including neglect; physical, psychological, sexual, or financial abuse; and self-neglect.
- The key to diagnosis is maintaining a high index of suspicion with every patient encounter with older adults.
- Certain patient and caregiver characteristics can help identify high risk for abuse.
- While the exact procedures may differ, most states and countries have mandatory reporting requirements, so knowledge of local reporting procedures is advisable.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Citations
Centers for Disease Control and Prevention. About abuse of older persons. Nov 2024 [internet publication].[Full Text]
American College of Obstetricians and Gynecologists' Committee on Health Care for Underserved Women. Elder abuse and women's health: ACOG Committee Opinion No 824. Obstet Gynecol. 2021 Mar 1;137(3):e89-93.[Abstract][Full Text]
Hirst SP, Penney T, McNeill S, et al. Best-practice guideline on the prevention of abuse and neglect of older adults. Can J Aging. 2016 Jun;35(2):242-60.[Abstract][Full Text]
National Institute for Health and Care Excellence. Safeguarding adults in care homes. Feb 2021 [internet publication].[Full Text]
1. Centers for Disease Control and Prevention. About abuse of older persons. Nov 2024 [internet publication].[Full Text]
2. World Health Organization. Abuse of older people. 2024 [internet publication].[Full Text]
3. Lachs MS, Pillemer KA. Elder Abuse. N Engl J Med. 2015 Nov 12;373(20):1947-56.[Abstract][Full Text]
4. U.S. Department of Justice. Red flags of elder abuse. Nov 2023 [internet publication].[Full Text]
5. McCreadie C. Introduction: the issues, practice and policy. In: Eastman M, ed. Old age abuse: a new perspective. London: Chapman & Hall; 1994:3-22.
6. O'Malley TA, O'Malley HC, Everitt DE, et al. Categories of family mediated abuse and neglect of elderly persons. J Am Geriatr Soc. 1984;32:362-369.[Abstract]
7. Yon Y, Mikton CR, Gassoumis ZD, et al. Elder abuse prevalence in community settings: a systematic review and meta-analysis. Lancet Glob Health. 2017 Feb;5(2):e147-56. [Abstract][Full Text]
8. Biggs S, Manthorpe J, Tinker A, et al. Mistreatment of older people in the United Kingdom: findings from the first National Prevalence Study. J Elder Abuse Negl. 2009 Jan-Mar;21(1):1-14. [Abstract]
9. Storey JE. Risk factors for elder abuse and neglect: A review of the literature. Aggression and Violent Behavior. 2020 Jan-Feb; 50; 101339. [Full Text]
10. Lindbloom EJ, Brandt J, Hough LD, et al. Elder mistreatment in the nursing home: a systematic review. J Am Med Direc Assoc. 2007 Nov;8(9):610-6.[Abstract]
11. Yon Y, Ramiro-Gonzalez M, Mikton CR, et al. The prevalence of elder abuse in institutional settings: a systematic review and meta-analysis. Eur J Public Health. 2019 Feb 1;29(1):58-67.[Abstract][Full Text]
12. Lachs MS, Williams C, O'Brien S, et al. Risk factors for reported elder abuse and neglect: a nine-year observational cohort study. Gerontologist. 1997 Aug;37(4):469-74.[Abstract]
13. Paveza GJ, Cohen D, Eisdorfer C, et al. Severe family violence and Alzheimer's disease: prevalence and risk factors. Gerontologist. 1992 Aug;32(4):493-7.[Abstract]
14. Pillemer K, Finkelhor D. The prevalence of elder abuse: a random sample survey. Gerontologist. 1988 Feb;28(1):51-7.[Abstract]
15. Melchiorre MG, Di Rosa M, Lamura G, et al. Abuse of older men in seven European countries: a multilevel approach in the framework of an ecological model. PLoS One. 2016 Jan 19;11(1):e0146425. [Abstract][Full Text]
16. World Health Organization. Addressing violence against children, women and older people during the covid-19 pandemic: Key actions. June 2020 [internet publication]. [Full Text]
17. Jones JS, Holstege C, Holstege H. Elder abuse and neglect: understanding the causes and potential risk factors. Am J Emerg Med. 1997;15:579-583.[Abstract]
18. McGarry J, Simpson C, Hinchliff-Smith K. The impact of domestic abuse for older women: a review of the literature. Health Soc Care Community. 2011;19:3-14.[Abstract]
19. Tatara T, Kuzmeskus LB, Duckhorn E, et al. The national elder abuse incidence study: final report. September 1998. http://www.aoa.gov (last accessed 24 March 2016).[Full Text]
20. Beach SR, Schulz R, Williamson GM, et al. Risk factors for potentially harmful informal caregiver behavior. J Am Geriatr Soc. 2005;53:255-261.[Abstract]
21. Buri H, Daly JM, Hartz AJ, et al. Factors associated with self-reported elder mistreatment in Iowa's frailest elders. Res Aging. 2006;28:562-581.
22. Dong XQ. Elder abuse: systematic review and implications for practice. J Am Geriatr Soc. 2015;63:1214-1238.[Abstract][Full Text]
23. American College of Obstetricians and Gynecologists' Committee on Health Care for Underserved Women. Elder abuse and women's health: ACOG Committee Opinion No 824. Obstet Gynecol. 2021 Mar 1;137(3):e89-93.[Abstract][Full Text]
24. Quinn MJ, Tomita SK. Elder abuse and neglect. 2nd ed. New York, NY: Springer; 1997:9-10.
25. Lowenstein SR, Crescenzi CA, Kern DC, et al. Care of the elderly in the emergency department. Ann Emerg Med. 1986;15:529-533.[Abstract]
26. Kosberg JI, Nahmiash D. Characteristics of victims and perpetrators and milieus of abuse and neglect. In: Baumhover LA, Beall SC, eds. Abuse, neglect, and exploitation of older persons: strategies for assessment and intervention. Baltimore, MD: Health Professions Press; 1996:31-49.
27. Lachs MS, Pillemer K. Abuse and neglect of elderly persons. N Engl J Med. 1995;332:437-443.[Abstract]
28. Steiner RP, Vansickle K, Lippmann SB. Domestic violence: do you know when and how to intervene? Postgrad Med. 1996;100:103-116.[Abstract]
29. Han SD, Mosqueda L. Elder abuse in the COVID-19 era. J Am Geriatr Soc. 2020 Jul;68(7):1386-7.[Abstract][Full Text]
30. Pillemer K, Burnes D, Riffin C, et al. Elder abuse: global situation, risk factors, and prevention strategies. Gerontologist. 2016 Apr;56(suppl 2):S194-205. [Abstract][Full Text]
31. Baker PR, Francis DP, Hairi NN, et al. Interventions for preventing abuse in the elderly. Cochrane Database Syst Rev. 2016;(8):CD010321.[Abstract][Full Text]
32. Ginschel F, Schlüter K. Education on old age and ageing in school: An analysis of students' conceptions of old age and ageing and implications for teaching. Education Sciences 2020;10:307.[Full Text]
33. Aguilera-Hermida P. Fighting ageism through intergenerational activities, a transformative experience. Journal of Transformative Learning. 2020;7(2), 6-18.[Full Text]
34. Hirst SP, Penney T, McNeill S, et al. Best-practice guideline on the prevention of abuse and neglect of older adults. Can J Aging. 2016 Jun;35(2):242-60.[Abstract][Full Text]
35. Aravanis SC, Adelman RD, Breckman R, et al. Diagnostic and treatment guidelines on elder abuse and neglect. Arch Fam Med. 1993 Apr;2(4):371-88.[Abstract]
36. Rathbone-McCuan E. Elderly victims of family violence and neglect. Soc Casework. 1980;61:296-304.
37. Fulmer T, Paveza G, Abraham I, et al. Elder neglect assessment in the emergency department. J Emerg Nurs. 2000 Oct;26(5):436-43.[Abstract]
38. American College of Emergency Physicians. Policy statement: management of elder abuse and neglect. Ann Emerg Med. 1998 Jan;31(1):149-50.[Abstract]
39. National Center for Elder Abuse. Elder abuse screening tools for healthcare professionals. 2016 [internet publication].[Full Text]
40. Rathbone-McCuan E, Voyles B. Case detection of abused elderly parents. Am J Psychiatry. 1982 Feb;139(2):189-92.[Abstract]
41. Fulmer T, Birkenhauer D. Elder mistreatment assessment as a part of everyday practice. J Gerontol Nurs. 1992 Mar;18(3):42-5.[Abstract]
42. Cooper C, Manela M, Katona C, et al. Screening for elder abuse in dementia in the LASER-AD study: prevalence, correlates and validation of instruments. Int J Geriatr Psychiatry. 2008 Mar;23(3):283-8.[Abstract]
43. Shugarman LR, Fries BE, Wolf RS, et al. Identifying older people at risk of abuse during routine screening practices. J Am Geriatr Soc. 2003 Jan;51(1):24-31.[Abstract]
44. National Institute for Health and Care Excellence. Safeguarding adults in care homes. Feb 2021 [internet publication].[Full Text]
45. Levy DB, Hanlon DP, Townsend RN. Geriatric trauma. Geriatr Emerg Care. 1993 Aug;9(3):601-20.[Abstract]
46. McGill: Department of Family Medicine. Elder Abuse Suspicion Index © (EASI). Feb 2006 [internet publication].[Full Text]
47. Neale AV, Hwalek MA, Scott RO, et al. Validation of the Hwalek-Sengstock elder abuse screening test. J Appl Gerontol. 1991 Dec;10(4):406-18.
48. Schofield MJ, Mishra GD. Validity of self-report screening scale for elder abuse: Women's Health Australia study. Gerontologist. 2003 Feb;43(1):110-20.[Abstract]
49. US Preverntive Service Task Force. Intimate partner violence and caregiver abuse of older or vulnerable adults: screening. Jun 2025 [internet publication].[Full Text]
50. American College of Emergency Physicians. Domestic family violence. Apr 2019 [internet publication].[Full Text]
51. Australian Institute of Family Studies. Elder abuse: understanding issues, frameworks and responses. February 2016 [internet publication].[Full Text]
52. Glasgow K, Fanslow JL. Family violence intervention guidelines: elder abuse and neglect. Wellington, New Zealand: Ministry of Health. 2006.[Full Text]
53. National Institute for Health and Care Excellence. Domestic violence and abuse: multi-agency working. February 2014 [internet publication].[Full Text]
54. Capezuti E, Brush BL, Lawson WT 3rd. Reporting elder mistreatment. J Gerontol Nursing. 1997 Jul;23(7):24-32.[Abstract]
55. Killick C, Taylor BJ. Professional decision making on elder abuse: systematic narrative review. J Elder Abuse Negl. 2009 Jul-Sep;21(3):211-38.[Abstract]
56. American College of Emergency Physicians. Recognition and management of elder abuse. January 1999 [internet publication].[Full Text]
57. Ploeg J, Fear J, Hutchison B, et al. A systematic review of interventions for elder abuse. J Elder Abuse Negl. 2009 Jul-Sep;21(3):187-210.[Abstract]
58. Jacobs DG. Special considerations in geriatric injury. Curr Opin Crit Care. 2003 Dec;9(6):535-9.[Abstract]
59. United Nations Programme on Ageing. The Madrid international plan of action on ageing. New York, NY; UN Department of Economics and Social Affairs: 2002.[Full Text]
60. Department of Health (UK). Safeguarding adults: the role of health services. Mar 2011 [internet publication].[Full Text]
61. Lachs MS, Williams CS, O'Brien S, et al. The mortality of elder mistreatment. JAMA. 1998;280:428-432.[Abstract][Full Text]
62. Dyer CB, Pavlik VN, Murphy KP, et al. The high prevalence of depression and dementia in elder abuse or neglect. J Am Geriatr Soc. 2000;48:205-208.[Abstract]
63. Canadian Task Force on the Periodic Health Examination. Periodic health examination, 1994 update: 4. secondary prevention of elder abuse and mistreatment. CMAJ. 1994;151:1413-1420.[Abstract][Full Text]
