Evaluation of Data Linkage Methodology to Improve Estimates of Elder Mistreatment

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DESCRIPTION (provided by applicant): Elder mistreatment is an important, understudied and under-reported public health problem and a high priority for the National Institute on Aging in light of the burgeoning United States elderly population. This project will evaluate the feasibility of applying data linkage methodology used successfully to improve estimates of intimate partner violence and child maltreatment to improve estimates of incidence and prevalence of elder mistreatment. Databases that provide information on reported elder mistreatment currently exist but have not been utilized to full advantage to provide both a national and local understanding of the extent of reported elder mistreatment and risk factors associated with mistreatment. Linkage of state-level data from databases generally available nationally will be conducted. The databases include Adult Protective Services, hospital Emergency Department and Hospital Discharge, Law Enforcement/Criminal Justice, Long Term Care, and the RI component of the National Violent Death Reporting System. Unduplicated counts of victims of physical, sexual, and psychological abuse as well as victims of neglect and financial exploitation will be obtained. Elders residing in both community and institutional settings will be included. This study will fill an important gap in knowledge by combining data on reported cases of elder mistreatment across reporting sources to afford the most complete picture possible of known cases. Risk factors for victimization and perpetration will also be assessed for use in detection of previously unrecognized cases. Capture-recapture methodology will be utilized to estimate the number of unreported cases. In addition, a multi-disciplinary Elder Mistreatment Assessment Working Group will be convened to develop standardized operational definitions for each type of elder mistreatment that can be applied across disciplines. The proposed methodology holds promise as methodology that could be applied nationally and, used in concert with survey data, significantly improve estimates of the incidence and prevalence of elder mistreatment. This application will fill an important gap in our knowledge by combining data on reported cases of elder mistreatment across reporting sources to afford us the most complete picture possible of known cases. Until this work is undertaken we will not know how representative cases from individual sources are of the population of all reported cases of elder mistreatment that occur. With this information and collection of survey data in the future, we will finally have a clearer picture of the extent of elder mistreatment in the population and have the information essential to develop and target more effective public health interventions.