Addressing the measurement challenge in elder abuse interventions: need for a severity framework.

The field of elder abuse is evolving toward an emphasis on intervention research. However, researchers currently rely on binary approaches to measure elder abuse phenomena, which fail to capture changes in problem status over the course of intervention. This commentary develops a case for severity as a framework to operationalize and measure elder abuse in intervention research and practice. A severity framework provides enhanced elder abuse measurement responsiveness and aligns with the dominant client-centered, harm-reduction clinical approach to intervening with elder abuse cases.

Staff conceptualisations of elder abuse in residential aged care: A rapid review.

OBJECTIVE: The purpose of this rapid review was to explore how residential aged care staff conceptualise and identify elder abuse. METHODS: English-language publications, between 2000 and 2017, about elder abuse in residential aged care in developed countries were sought from three academic databases. Only perspectives on staff-to-resident and resident-to-resident abuse were included. RESULTS: Over 2000 articles were screened, and 19 journal articles were included in the review. A wide range of abusive behaviours was identified, but there was little common understanding of what constituted elder abuse. Furthermore, disparities in conceptualisations were greater for certain types of abuse (e.g. verbal, psychological and caregiving). CONCLUSION: Elder abuse in residential aged care was conceptualised and identified by staff in diverse and different ways. This lack of common understanding hinders the development of effective interventions and prevention strategies, which include staff education and training as well as significant structural and institutional changes.

Identifying and Initiating Intervention for Elder Abuse and Neglect in the Emergency Department.

Elder abuse and neglect are common and may have serious medical and social consequences but are infrequently identified. An emergency department (ED) visit represents a unique but usually missed opportunity to identify potential abuse and initiate intervention. ED assessment should include observation of patient-caregiver interaction, comprehensive medical history, and head-to-toe physical examination. Formal screening protocols may also be useful. ED providers concerned about elder abuse or neglect should document their findings in detail. ED interventions for suspected or confirmed elder abuse or neglect include treatment of acute medical, traumatic, and psychological issues; ensuring patient safety; and reporting to the authorities.

Using Latent Class Analysis to Identify Profiles of Elder Abuse Perpetrators.

Objectives: Research suggests that abuser risk factors differ across elder mistreatment types, but abuse interventions are not individualized. To move away from assumptions of perpetrator homogeneity and to inform intervention approaches, this study classifies abusers into subtypes according to their behavior profiles. Method: Data are from the Older Adult Mistreatment Assessment administered to victims by Adult Protective Service (APS) in Illinois. Latent class analysis was used to categorize abusers (N = 336) using victim and caseworker reports on abusers' harmful and supportive behaviors and characteristics. Multinomial logistic regression was then used to determine which abuser profiles are associated with 4 types of mistreatment-neglect, physical, emotional, and financial-and other sociodemographic characteristics. Results: Abusers fall into 4 profiles descriptively labeled "Caregiver," "Temperamental," "Dependent Caregiver," and "Dangerous." Dangerous abusers have the highest levels of aggression, financial dependency, substance abuse, and irresponsibility. Caregivers are lowest in harmful characteristics and highest in providing emotional and instrumental support to victims. The 4 profiles significantly differ in the average age and gender of the abuser, the relationship to victims, and types of mistreatment committed. Discussion: This is the first quantitative study to identify and characterize abuser subtypes. Tailored interventions are needed to reduce problem behaviors and enhance strengths specific to each abuser profile.

[Elder abuse: Twenty years later]. / Maltrato y abuso en la vejez: veinte años después.

This article analyzes various aspects of elder abuse. Subtypes of abuse, neglect and self-neglect are defned. The phenomenon is analyzed in the context of geriatric institutions, people with dementia, and among the gay, lesbian and trans people. The narrative model is used to exemplify various situations, using authors such as Irving, Ford and Lodge.

An assessment of interventions that target risk factors for elder abuse.

Although there is increasing concern about both the prevalence of, and harms associated with the abuse of older adults, progress in the development of interventions to prevent its occurrence has been slow. This paper reports the findings of a systematic review of the published literature that identified studies in which the outcomes of preventative interventions are described. A total of eight different intervention trials, published since 2004, are described across the primary, secondary and tertiary levels of prevention and in terms of the types of risk factor that they target. The current evidence to support the effectiveness of these interventions is not only limited by the small number of outcome studies but also the poor quality of evaluation designs and the focus of many interventions on single risk factors. It is concluded that work is needed to strengthen the evidence base that supports the delivery of interventions to prevent elder abuse.

Describing visible acute injuries: development of a comprehensive taxonomy for research and practice.

BACKGROUND: Little literature exists classifying and comprehensively describing intentional and unintentional acute injuries, which would be valuable for research and practice. In preparation for a study of injury patterns in elder abuse, our goal was to develop a comprehensive taxonomy of relevant types and characteristics of visible acute injuries and evaluate it in geriatric patients. METHODS: We conducted an exhaustive review of the medical and forensic literature focusing on injury types, descriptions, patterns and analyses. We then prepared iteratively, through consensus with a multidisciplinary, national panel of elder abuse experts, a comprehensive classification system to describe these injuries. RESULTS: We designed a three-step process to fully describe and classify visible acute injuries: (1) determining the type of injury, (2) assigning values to each of the characteristics common to all geriatric injuries and (3) assigning values to additional characteristics relevant for specific injuries. We identified nine unique types of visible injury and seven characteristics critical to describe all these injuries, including body region(s) and precise anatomic location(s). For each injury type, we identified two to seven additional critical characteristics, such as size, shape and cleanliness. We pilot tested it on 323 injuries on 83 physical elder abuse victims and 45 unintentional fall victims from our ongoing research to ensure that it would allow for the complete and accurate description of the full spectrum of visible injuries encountered and made modifications and refinements based on this experience. We then used the classification system to evaluate 947 injuries on 80 physical elder abuse victims and 195 unintentional fall victims to assess its practical utility. CONCLUSIONS: Our comprehensive injury taxonomy systematically integrates and expands on existing forensic and clinical research. This new classification system may help standardise description of acute injuries and patterns among clinicians and researchers.

Interventions for preventing abuse in the elderly.

BACKGROUND: Maltreatment of older people (elder abuse) includes psychological, physical, sexual abuse, neglect and financial exploitation. Evidence suggests that 10% of older adults experience some form of abuse, and only a fraction of cases are actually reported or referred to social services agencies. Elder abuse is associated with significant morbidity and premature mortality. Numerous interventions have been implemented to address the issue of elder maltreatment. It is, however, unclear which interventions best serve to prevent or reduce elder abuse. OBJECTIVES: The objective of this review was to assess the effectiveness of primary, secondary and tertiary intervention programmes used to reduce or prevent abuse of the elderly in their own home, in organisational or institutional and community settings. The secondary objective was to investigate whether intervention effects are modified by types of abuse, types of participants, setting of intervention, or the cognitive status of older people. SEARCH METHODS: We searched 19 databases (AgeLine, CINAHL, Psycinfo, MEDLINE, Embase, Proquest Central, Social Services Abstracts , ASSIA, Sociological Abstracts, ProQuest Dissertations & Theses Global, Web of Science, LILACS, EPPI, InfoBase, CENTRAL, HMIC, Opengrey and Zetoc) on 12 platforms, including multidisciplinary disciplines covering medical, health, social sciences, social services, legal, finance and education. We also browsed related organisational websites, contacted authors of relevant articles and checked reference lists. Searches of databases were conducted between 30 August 2015 and 16 March 2016 and were not restricted by language. SELECTION CRITERIA: We included randomised controlled trials (RCTs), cluster-randomised trials, and quasi-RCTs, before-and-after studies, and interrupted time series. Only studies with at least 12 weeks of follow-up investigating the effect of interventions in preventing or reducing abuse of elderly people and those who interact with the elderly were included. DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data and assessed the studies' risk of bias. Studies were categorised as: 1) education on elder abuse, 2) programmes to reduce factors influencing elder abuse, 3) specific policies for elder abuse, 4) legislation on elder abuse, 5) programmes to increase detection rate on elder abuse, 6) programmes targeted to victims of elder abuse, and 7) rehabilitation programmes for perpetrators of elder abuse. All studies were assessed for study methodology, intervention type, setting, targeted audience, intervention components and intervention intensity. MAIN RESULTS: The search and selection process produced seven eligible studies which included a total of 1924 elderly participants and 740 other people. Four of the above seven categories of interventions were evaluated by included studies that varied in study design. Eligible studies of rehabilitation programmes, specific policies for elder abuse and legislation on elder abuse were not found. All included studies contained a control group, with five of the seven studies describing the method of allocation as randomised. We used the Cochrane 'Risk of bias' tool and EPOC assessment criteria to assess risk of bias. The results suggest that risk of bias across the included body of research was high, with at least 40% of the included studies judged as being at high risk of bias. Only one study was judged as having no domains at high risk of bias, with two studies having two of 11 domains at high risk. One study was judged as being at high risk of bias across eight of 11 domains.All included studies were set in high-income countries, as determined by the World Bank economic classification (USA four, Taiwan one, UK two). None of the studies provided specific information or analysis on equity considerations, including by socio-economic disadvantage, although one study was described as being set in a housing project. One study performed some form of cost-effectiveness analysis on the implementation of their intervention programmes, although there were few details on the components and analysis of the costing.We are uncertain whether these interventions reduce the occurrence or recurrence of elder abuse due to variation in settings, measures and effects reported in the included studies, some of which were very small and at a high risk of bias (low- and very low-quality evidence).Two studies measured the occurrence of elder abuse. A high risk of bias study found a difference in the post-test scores (P value 0.048 and 0.18). In a low risk of bias study there was no difference found (adjusted odds ratio (OR) =0.48, 95% 0.18 to 1.27) (n = 214). For interventions measuring abuse recurrence, one small study (n = 16) reported no difference in post-test means, whilst another found higher levels of abuse reported for the intervention arms (Cox regression, combined intervention hazard ratio (HR) = 1.78, alpha level = 0.01).It is uncertain whether targeted educational interventions improve the relevant knowledge of health professionals and caregivers (very low-quality evidence), although they may improve detection of resident-to-resident abuse. The concept of measuring improvement in detection or reporting as opposed to measuring the occurrence or recurrence of abuse is complicated. An intervention of public education and support services aimed at victims may also improve rates of reporting, however it is unclear whether this was due to an increase in abuse recurrence or better reporting of abuse.The effectiveness of service planning interventions at improving the assessment and documentation of related domains is uncertain. Unintended outcomes were not reported in the studies. AUTHORS' CONCLUSIONS: There is inadequate trustworthy evidence to assess the effects of elder abuse interventions on occurrence or recurrence of abuse, although there is some evidence to suggest it may change the combined measure of anxiety and depression of caregivers. There is a need for high-quality trials, including from low- or middle-income countries, with adequate statistical power and appropriate study characteristics to determine whether specific intervention programmes, and which components of these programmes, are effective in preventing or reducing abuse episodes among the elderly. It is uncertain whether the use of educational interventions improves knowledge and attitude of caregivers, and whether such programmes also reduce occurrence of abuse, thus future research is warranted. In addition, all future research should include a component of cost-effectiveness analysis, implementation assessment and equity considerations of the specific interventions under review.

Experience of elder abuse among older Korean immigrants.

Studies on the scope and nature of Asian American elder abuse conducted with older immigrants are extremely limited. The overall purpose of this study was to examine the extent and type of elder abuse among older Korean immigrants, and to investigate critical predictors of elder abuse in this population. The sample consisted of 200 older Korean immigrants aged 60 to 90 years who resided in Los Angeles County in 2008. One of the key findings indicated that 58.3% of respondents experienced one or more types of elder abuse. Logistic regression indicated that the victims' health status and educational level were statistically significant predictors of the likelihood of experiencing abuse. The present study, although limited in sample size, measures, sampling methods, and population representation, has contributed to this important area of knowledge. It is recommended that future studies conduct research on elder abuse with more representative national samples that can measure the extent of abuse and neglect more accurately.

Five-year all-cause mortality rates across five categories of substantiated elder abuse occurring in the community.

Elder abuse increases the likelihood of early mortality, but little is known regarding which types of abuse may be resulting in the greatest mortality risk. This study included N = 1,670 cases of substantiated elder abuse and estimated the 5-year all-cause mortality for five types of elder abuse (caregiver neglect, physical abuse, emotional abuse, financial exploitation, and polyvictimization). Statistically significant differences in 5-year mortality risks were found between abuse types and across gender. Caregiver neglect and financial exploitation had the lowest survival rates, underscoring the value of considering the long-term consequences associated with different forms of abuse. Likewise, mortality differences between genders and abuse types indicate the need to consider this interaction in elder abuse case investigations and responses. Further mortality studies are needed in this population to better understand these patterns and implications for public health and clinical management of community-dwelling elder abuse victims.

All Elder Abuse Perpetrators Are Not Alike: The Heterogeneity of Elder Abuse Perpetrators and Implications for Intervention.

The tendency to label all elder abuse perpetrators as the "bad guys" has diminished our ability to respond effectively. A review of the literature demonstrates that elder abuse perpetrators are in fact heterogeneous with important differences across types of abuse. A reformulation of perpetrator interventions away from a singular emphasis on prosecution to meaningful alternatives that utilize criminal justice and/or therapeutic approaches tailored to the needs of the case is needed. These interventions must incorporate the needs of both victims and perpetrators, take into consideration the type of abuse involved, acknowledge the variations in perpetrator culpability, and recognize the continuum of complexity among these cases. Without addressing these nuances, intervention and prevention efforts will be futile if not harmful.

[A sociography of elderly victims of family violence in Portugal]. / Estudo sobre pessoas idosas vítimas de violência em Portugal: sociografia da ocorrência.

This article presents data on violence against persons aged 60 years or older and living in Portugal for at least 12 months. The cross-sectional descriptive study collected data with a face-to-face questionnaire applied to victims that had sought assistance at three government institutions and one non-governmental support service for victims. The non-probabilistic sample included 510 victims of violence in family settings. Physical and psychological violence were the most common (87.8% and 69.6%, respectively). Financial violence was reported by 47.5% of the victims, followed by sexual assault (7.5%) and neglect (6.5%). The majority of victims (74.1%) reported more than one type of violence. Victims were mostly women, and mean age was 70.7 years. Most of the perpetrators belonged to the nuclear family, namely spouses or partners, sons/sons-in-law, and daughters/daughters-in-law. However, differences were observed according to victim's gender. The results indicate that violence is not a uniform phenomenon, presenting different configurations.

Psychological the most common elder abuse in a Havana neighborhood.

INTRODUCTION: Globally, older adults are a population group that often suffers abuse by their caregivers. Along with women and children, they are among those most often reported as victims of abuse of any kind in Cuba. OBJECTIVE: Characterize presence of domestic abuse of older adults in family doctor-and-nurse office No. 28 of the Carlos Manuel Portuondo University Polyclinic in Havana, Cuba, determining the main manifestations of abuse and help-seeking behavior by the older adults identified as victims. METHOD: This was a descriptive cross-sectional study of adults aged ≥ 60 years; all those not diagnosed with dementia and who agreed to participate were interviewed. In a universe of 268 older adults, 29 were living outside the area, 24 declined to participate, and 18 had a diagnosis of dementia, leaving a study population of 197 individuals. Variables included: personal experience of abuse, type of abuse, perpetrator, help sought, and reasons for not seeking help. Statistical analysis was based on percentages. RESULTS: Of 197 older adults interviewed, 88 (44.7%) reported that they were victims of domestic abuse; 50 of these were women. The most common types of abuse were psychological abuse and disrespect for personal space, reported by 69 (78.4%) and 54 (61.4%) individuals, respectively. Sons- and daughters-in-law were identified as the abusers by 68 participants and grandchildren by 65. Of the 88 victims, 67 (76.1%) stated that they did not seek help. CONCLUSIONS: The finding that substantial numbers of older adults are victims of domestic abuse brings to light a hitherto insufficiently addressed issue in the community studied. More research is needed to deepen understanding of the scope and causes of the problem to inform prevention and management strategies, not only at the level of the polyclinic catchment area, but in the health system in general.

Estudo sobre pessoas idosas vítimas de violência em Portugal: sociografia da ocorrência / A sociography of elderly victims of family violence in Portugal / Estudio sobre las víctimas de la violencia en Portugal: sociografía de la ocurrencia

O presente artigo apresenta dados sobre violência contra pessoas com 60 e mais anos residentes em Portugal há mais de 12 meses. O estudo transversal e descritivo recolheu dados por meio de um questionário aplicado presencialmente a vítimas que recorreram a três entidades governamentais e a uma instituição não-governamental de apoio a vítimas. A amostra não probabilística foi constituída por 510 vítimas de violência em contexto familiar. A violência física e a psicológica foram os tipos mais reportados, afetando 87,8% e 69,6% das pessoas estudadas, seguindo-se a violência financeira (47,5%), sexual (7,5%) e a negligência (6,5%). A maioria (74,1%) dos respondentes indicou mais de um tipo de violência. As vítimas, na maioria mulheres, tinham uma média de idade de 70,7 anos. A maioria dos agressores pertencia à família nuclear, nomeadamente, cônjuges ou companheiros, filhos/enteados e filhas/enteadas. Contudo, observaram-se diferenças no agressor consoante o gênero da vítima. Os resultados indicam que a violência não é um fenômeno uniforme, apresentando-se sob diferentes configurações.

This article presents data on violence against persons aged 60 years or older and living in Portugal for at least 12 months. The cross-sectional descriptive study collected data with a face-to-face questionnaire applied to victims that had sought assistance at three government institutions and one non-governmental support service for victims. The non-probabilistic sample included 510 victims of violence in family settings. Physical and psychological violence were the most common (87.8% and 69.6%, respectively). Financial violence was reported by 47.5% of the victims, followed by sexual assault (7.5%) and neglect (6.5%). The majority of victims (74.1%) reported more than one type of violence. Victims were mostly women, and mean age was 70.7 years. Most of the perpetrators belonged to the nuclear family, namely spouses or partners, sons/sons-in-law, and daughters/daughters-in-law. However, differences were observed according to victim’s gender. The results indicate that violence is not a uniform phenomenon, presenting different configurations.

Este artículo presenta datos sobre la violencia contra las personas de 60 años o más que reside en Portugal desde hace más de 12 meses. Se trata de un estudio descriptivo y transversal que recogió datos a través de un cuestionario respondido presencialmente por las víctimas que recurren a tres entidades de gobierno y una organización no gubernamental. La muestra no probabilística constaba de 510 víctimas de violencia familiar. La violencia física y psicológica fueron los tipos más detectados, afectando a un 87,8% y el 69,6% de los estudiados, seguida por la violencia económica (47,5%), sexual (7,5%) y negligencia (6,5%). La mayoría (74,1%) de los encuestados indica más de un tipo de violencia. Las víctimas, en su mayoría mujeres, tenían una edad media de 70,7 años. La mayoría de los atacantes pertenecían a la familia nuclear, incluidos los cónyuges o parejas, hijos/hijastros e hijas/hijastras. Sin embargo, hubo diferencias en función del sexo de la víctima-abusador. Los resultados indican que la violencia no es un fenómeno uniforme, apareciendo en diferentes configuraciones.

Do the definitions of elder mistreatment subtypes matter? Findings from the PINE Study.

BACKGROUND: Elder mistreatment (EM) is a pervasive public health issue and is associated with morbidity and premature mortality. This study aimed to examine how the prevalence of EM and its subtypes vary using different definitions among U.S. Chinese older adults. METHODS: The Population Study of Chinese Elderly in Chicago is a population-based epidemiological survey of 3,159 U.S. Chinese older adults in the Greater Chicago area that is guided by a community-based participatory research approach. Participants answered questions regarding psychological, physical, and sexual abuse, caregiver neglect, and financial exploitation. Definitional approaches for EM and its subtypes were constructed from least restrictive to most restrictive. RESULTS: Using different definitional criteria, the prevalence of psychological abuse was 1.1%-9.8%, physical abuse was 1.1%, sexual abuse was 0.2%, caregiver neglect was 4.6%-11.1%, and financial exploitation was 8.8%-9.3%. Overall, EM varied from 13.9% to 25.8%, depending on the defining criteria. Regardless of the definition used, those who experienced EM were more likely to be older and have higher educational attainment, poor health status, poor quality of life, and worsened health change in the last year. However, among the different definitions of overall EM, there were no statistically significant differences across sociodemographic characteristics or self-reported health status associated with EM criteria. CONCLUSIONS: Elder mistreatment is prevalent among U.S. Chinese older adults regardless of the definitional criteria. Sociodemographic characteristics associated with EM did not differ by definitional criteria. Future longitudinal studies are needed to quantify the risk and protective factors associated with EM in Chinese aging populations.

Neglect and abuse of older people in Nepal: a commentary on "A baseline study on reported cases of elder abuse in Nepali press".

Little is known about elder abuse in Nepal. To gain further insights, the National Human Rights Commission in association with the Geriatric Center in Nepal published a report that analyzes all cases of older people's abuse published in two daily newspapers in Nepal over a 2-year period. This commentary discusses the main findings of the report, as well as future directions.

[Myiasis because of neglect]. / Fliegenmadenkrankheit (Myiasis) bei Verwahrlosung alter/kranker Menschen.

Myiasis is known as the infestation of living organisms with maggots. It is often caused by (self-) neglect. Eight cases of myiasis have been examined at the Institute of Legal Medicine in Hamburg between 2002 and 2014. It is important that the medical examiner compares the maggots' stage of development with the alleged time of death. Especially in cases of home care, myiasis and neglect are suspicious and deserve special attention.

Older people's perceptions of the term elder abuse and characteristics associated with a lower level of awareness.

A national representative survey of 2,021 community-dwelling older people was carried out in 2010 using face-to-face interviews. The study examined how the term "elder abuse" was understood by this population and identified factors associated with lower levels of awareness. Over 80% of this population recognized the term elder abuse, and 56% demonstrated specific insight related to typologies, locations, and perpetrators of abuse. Less specific responses were given by 22% of participants, and a further 21% could not give a reply. Less specific or "don't know" responses were independently associated with age 80 years or older, a lower level of education, impaired physical health, and living in economically deprived communities. Despite ongoing public information campaigns, there remained a significant portion of older people who may be unaware of or have limited insight into elder abuse. This study suggests a need for more targeted education campaigns aimed at specific higher-risk groups.

Association between reported elder abuse and rates of admission to skilled nursing facilities: findings from a longitudinal population-based cohort study.

BACKGROUND: Elder abuse is common and is a frank violation of an older adult's fundamental rights to be safe and free of violence. Our prior study indicates elder abuse is independently associated with mortality. This study aims to quantify the relationship between overall elder abuse and specific subtypes of elder abuse and rate of admission to skilled nursing facilities (SNF). METHODS: A prospective population-based study conducted in Chicago of community-dwelling older adults who participated in the Chicago Health and Aging Project (CHAP). Of the 6,674 participants in the CHAP study, 106 participants were reported to the social services agency for elder abuse. The primary predictor was elder abuse reported to the social services agency. The outcome of interest was the annual rate of admission to SNF obtained from the Center for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships. RESULTS: The average annual rate of SNF for those without elder abuse was 0.14 (0.58) and for those with elder abuse was 0.66 (1.63). After adjusting for sociodemographic and socioeconomic variables, medical comorbidities, cognitive and physical function, and psychosocial wellbeing, older adults who have been abused had higher rates of SNF admission (RR 4.60 (2.85-7.42)). Psychological abuse (RR 2.31 (1.17-4.56)), physical abuse (RR 2.36 (1.19-4.66)), financial exploitation (RR 2.81 (1.53-5.17)) and caregiver neglect (RR 4.73 (3.03-7.40)) were associated with increased rates of admission to SNF, after considering the same confounders. Elder abuse is associated with a higher rate of SNF stay longer than 30 days (RR 6.27 (3.68-10.69)). CONCLUSION: Elder abuse was associated with increased rates of admission to SNF in this community population. Specific subtypes of elder abuse had a differential association with an increased rate of admission to SNF.

Development and psychometric properties of the Geriatric Mistreatment Scale.

AIM: Elder mistreatment is a phenomenon that has increased proportionally to the increase in the number of older adults in different populations of the world. So far, in Mexico there is no instrument measuring and assessing this phenomenon. The objective of the present study was to develop and to know some psychometric properties of the Geriatric Mistreatment Scale (GMS). METHODS: A documentary and qualitative investigation was undertaken to contextualize the mistreatment phenomenon in Mexico. Each item was included in the preliminary version if it obtained 80% or greater agreement by experts (content validity). The preliminary scale (49-item) was applied to 626 older adults using a probabilistic sample representative of the older adults living in Mexico City. Then a statistical process was carried out to reduce the number of items, prove their internal consistency and associations with other measurements. The 22-item final version of the GMS that assesses physical, psychological, neglect, economic mistreatment and sexual abuse is reported herein. RESULTS: The mean age of participants was 71.94 ± 8 years. The internal consistency (Cronbach's alpha = 0.83) was appropriate. Subject memory complaint, depression, functional dependence and other measurements were associated with overall mistreatment. Regarding prevalence, 10.28% reported having experienced at least one type of mistreatment. CONCLUSION: The 22-item GMS had an acceptable internal consistency; the relationship with other measurements was significant according to the hypotheses. Therefore, the GMS is recommended for the screening of the five different types of elder mistreatment.