one of four cohorts funded by NIA (Lachs et al., 1996). In inception year 1982, the study sample consisted of 2,812 community-dwelling older adults over age 65. A manual record matching of EPESE and Connecticut ombudsman/elderly protective service records was done to determine if any cohort members had been seen by ombudsmen over an 11-year follow-up period from cohort inception (1982-1992 inclusive). After cohort members who were seen by protective services for the elderly were identified, weighted survival curves from cohort inception were constructed for three subgroups of subjects: (1) those found to have sustained verified elder mistreatment (abuse, neglect, or exploitation) by another party (i.e., nonself-neglect), (2) those seen by protective services for corroborated self-neglect, or (3) other members of the cohort who had no contact with elderly protective services.

Lack of Control Groups

Much of the data on risk factors and consequences of elder mistreatment are drawn from studies of clinical case samples. However, few of these studies have used controlled designs. For this reason, generalizations made from the existing studies are necessarily suspect. For example, some investigators have asserted that the abused elderly tend to be physically or mentally impaired or both. However, without a comparison group, it is impossible to know if they are more or less impaired than other persons. Several studies have attempted to go beyond previous efforts by interviewing the victims themselves and including a control group of nonabused elderly persons (Bristowe and Collins, 1989; Paveza et al., 1992; Pillemer and Finkelhor, 1988). These are still few and far between, however. Interestingly, although a number of controlled studies were conducted in the late 1980s and early 1990s, there are virtually no examples of more recent case-control studies of elder mistreatment.

Lack of Systematic Evaluation Studies

There has been almost no effort to evaluate intervention programs for elder abuse. Certainly, no study has as yet attempted a randomized control group design in this area. Any kind of experimental demonstration project is rare. Little is known about the relative effectiveness of various programs.

Summary

Due to such shortcomings, existing studies have not provided adequate data needed to answer three important public policy questions about elder abuse and neglect:



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