difference (conceptually or morally) between caretaker neglect of a 35-year-old with mental retardation and of a 65-year-old with dementia. So too with financial exploitation and other forms of abuse. Setting children to one side, the relevant population of vulnerable adults includes all persons with impairments or disabilities, such as mental retardation or impairments of capacity for mobility, associated with diminished capacity for self-protection. Not surprisingly, most adult protective services statutes include elder abuse and neglect within the broader category of vulnerable adults. Also, legislation designed to protect institutionalized persons (which includes psychiatric hospitals and mental retardation facilities as well as nursing homes) typically codify the right to be free of “abuse and neglect.”

Having said this, however, the panel recognizes that the categorical channeling of research funding (as well as protective legislation) along the path of aging gives particular salience to vulnerability associated with aging (as opposed to other conditions). The National Institute on Aging has commissioned the panel’s study, and a special focus on elders establishes the policy framework within which we are working. Accordingly, within the larger domain of adult protection, this report gives special attention to the aspects of research that focus on people who are vulnerable to mistreatment due to aging. However, this does not mean that “vulnerability associated with aging” should be defined categorically in terms of some particular age cutoff, such as 65. Even for legal purposes, the age of eligibility for benefits tied to older age varies—e.g., 65 for social security, 60 for programs funded under the Older Americans Act, 60 or 65 under adult protective services statutes. (Interestingly, the threshold age of protection under the Age Discrimination in Employment Act is 40.) For research purposes, a category defined as persons 65 or over would be both overinclusive and underinclusive—since many people over 65 are not vulnerable and some younger than 65 are vulnerable due to aging (e.g., dementias). In sum, the panel regards “older age” as one of the risk factors that should be explored empirically under the rubric of “vulnerability associated with aging.” As the field of elder mistreatment develops, surveillance and research must attend specifically to age as well as other indicators of vulnerability. (The panel’s conceptual vocabulary is depicted in Figures 2-4 and 2-5.)


In science, good measurement has several prerequisites. The first is a concept of what is being measured. In this case the object of measurement is the occurrence of elder mistreatment using the vocabulary and definitions presented above. The second prerequisite is an operational definition of the concept being explored so that it is objectively ascertainable in the field. Operational definitions in the domain of elder mistreatment are compli-

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