Primary Care Clinics for Estimating Prevalence & Incidence of Elder Mistreatment

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DESCRIPTION (provided by applicant): Elder Mistreatment (EM) is a potentially fatal public health problem that causes human suffering and preventable morbidity and mortality. Infected pressure ulcers, urine burns, fractures, depression and death are examples of the horrific outcomes of EM. Consistent with the mission of NIA, we intend to improve the health and well-being of older adults by detecting and treating EM. The goal of this study is to screen 640 older adults who visit their doctors at 5 primary care clinics for elder mistreatment. The new model will incorporate an elder mistreatment assessment instrument during the patient visit, administered by trained clinician screeners. When EM is screened positive, it will be verified by an expert team. Further, we will explore the feasibility and acceptability of re-screening at 6 months in a follow-up clinic visit to detect incidence of EM. Our aims will be to 1) estimate the prevalence of elder mistreatment in a large urban sample of community-dwelling elderly persons, via screening by clinicians with a valid, reliable instrument in community primary care clinics, 2) estimate the six-month incidence of elder mistreatment (EM), via screening and subsequent re-screening by clinicians, 3) compare a standardized, valid, reliable instrument, the Elder Assessment Instrument (EAI-R), which screens elders for psychological abuse, physical abuse and neglect by caregivers with a newly- developed single-item screening question, in this large sample of urban community-dwelling elderly persons. A cross-sectional study design will be used to address the first specific aim, to estimate the prevalence of elder mistreatment (EM) while a prospective cohort study design will be used to address the second specific aim, to estimate the six-month incidence of EM. Elder mistreatment is a potentially fatal public health problem that causes human suffering and preventable morbidity and mortality. Infected pressure ulcers, excoriations from urine burns, fractures, depression and death are examples of the horrific outcomes of elder mistreatment. This study will explore the feasibility of screening for the prevalence and incidence of elder mistreatment in busy primary care clinics. We will develop and test effective strategies for screening for elder mistreatment that can be replicated nationally.