those factors and thus prevent the development of new cases of elder mistreatment or deter the progression of existing cases. Third, understanding risk factors is critical to the development of public policy initiatives. It is necessary to identify populations at higher risk, and the causes of that heightened risk, before the costs and benefits of reducing exposure can be determined (Gordis, 1996).

A note on terminology will be useful at the outset. For the purposes of this chapter, following Timmreck (1998), risk factors are defined as experiences, behaviors, aspects of lifestyle or environment, or personal characteristics that increase the chances that elder mistreatment will occur. Increased risk factor exposure increases the probability of the occurrence of elder mistreatment. As noted in Chapter 2, a distinction can be made between risk factors (factors that increase the probability that a problem will occur) and protective factors (factors that decrease the probability of occurrence). To simplify the discussion, in the rest of the chapter we refer to risk factors only, in part because most published work involves variables associated with an increased probability of mistreatment. The discussion of risk factors, however, may also hold for protective factors. In fact, research on protective factors may be as important as study of factors that increase risk, since it may suggest factors that can be put in place as a means of preventing elder mistreatment.

PROBLEMS IN THE RESEARCH BASE

Prior to summarizing the available findings, it is important to review briefly the problems in using existing research to establish risk factors for elder mistreatment. Problems exist in two areas: (1) the nature of the phenomenon of elder mistreatment itself creates challenges for risk factor research and (2) specific methodological limitations of existing studies limit the ability to integrate findings.

Nature of Elder Mistreatment

With some diseases or conditions, attribution of cause can be fairly simple and straightforward; a salmonella outbreak serves as an example. Other conditions have very complex causation, and indeed the condition itself may be difficult to define and identify. Elder mistreatment clearly fits the latter pattern.

The complexity of elder mistreatment can be highlighted by reference to the concept of a “geriatric syndrome”—that is, common clinical problems that typically do not have a single underlying pathophysiological process, but instead have several contributing factors that shape presentation



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