More than 10% of older adults at risk of elder abuse

By: James Dean ,  Cornell Chronicle
Tue, 08/17/2021

More than 1 in 10 older adults in New York state – over 360,000 people – may become victims of elder mistreatment over the next decade, estimates a first-of-its-kind study by collaborators from Cornell and the University of Toronto.

They determined that poor health is a major risk factor, and that people who transition to living alone are more likely to suffer financial abuse. Black older adults also are at higher risk of financial abuse, a previously unreported racial disparity.

Tracking the incidence of mistreatment over time among hundreds of older adults who hadn’t previously been victims, the study confirms elder abuse is widespread and advances understanding of risk factors that should inform efforts to detect and prevent mistreatment, the researchers said.

“This study contributes to a growing base of evidence that elder mistreatment is a highly prevalent problem that demands a vigorous public health response,” said Karl Pillemer, the Hazel E. Reed Professor in the Department of Human Development in the College of Human Ecology (CHE) and professor of gerontology in medicine at Weill Cornell Medicine (WCM). “It’s a call to action for both the state and the country to think about how to better assist victims.”

The study, “Estimated Incidence and Factors Associated with Risk of Elder Mistreatment in New York State,” was published Aug. 12 in JAMA Network Open. The research was funded by a grant from the National Institute on Aging, part of the National Institutes of Health.

David Burnes, associate professor at the University of Toronto’s Factor-Inwentash Faculty of Social Work, is the study’s lead author. Pillemer is a senior author and Cornell co-authors include John Eckenrode, professor emeritus of human development (CHE); Dr. Mark Lachs, the Irene and Roy Psaty Distinguished Professor of Medicine (WCM); and David Hancock, a postdoctoral researcher in WCM’s Division of Geriatrics and Palliative Medicine.

Previous studies have measured the prevalence of elder mistreatment at points in time, including estimates of 15.7% globally and 9.5% in the United States. But the research team said such snapshots could not draw strong conclusions about the causes of mistreatment, for example whether someone’s poor health had led to abuse or resulted from abuse.

“Until you can look at people over time,” Burnes said, “you don’t have enough data to understand what you can do to help to prevent elder mistreatment.”

The new study followed older adults over a 10-year period. In 2019, the researchers followed up with nearly 630 participants in a 2009 survey conducted by several of members of the research team, called the New York State Elder Mistreatment Study.

In the earlier survey, this sample reported no experience with mistreatment in five categories: financial abuse, emotional abuse, physical abuse, neglect and sexual abuse. But a decade later, 11.4% reported having become victims of elder mistreatment, the study found. Financial abuse was the most common type, affecting 8.5% of respondents, followed by emotional abuse (4.1%), physical abuse (2.3%) and neglect (1%). No sexual abuse was reported.

“Given the scope of this issue,” the scholars wrote, “the development of prevention programs that either forestall initial onset of [elder mistreatment] among older adults or support existing victims are urgently needed.”

The study increases confidence that poor health is indeed an important risk factor, the authors said. That means healthcare providers could play an important role in screening older adults and providing education and referrals for at-risk patients, practices that have proven effective in addressing child neglect and abuse.

“If elder abuse victims are more likely to be in poor health,” Pillemer said, “their primary care physicians may be the front line of defense when it comes to treating elder abuse.”

In addition, he said, the greater risk of financial mistreatment among Black older adults warrants further research and reveals a need for culturally sensitive prevention programs that consider race as a potential vulnerability.

“This finding highlights an important form of racial disparity requiring urgent attention,” the authors wrote.

Pillemer said the team’s findings in New York state likely apply more broadly, given its large and diverse population. The study likely underestimates the incidence of elder mistreatment, the authors said, since research has shown older adults tend to underreport personal problems, and the population is aging.

“The only indication,” Pillemer said, “is that these numbers will increase as the older population increases.”

People who suspect elder mistreatment should contact the adult protective services agency in their state or county, Pillemer said.