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Invited Commentary
May 20, 2019

Interconnections in Violence Over the Life Course: From Cradle to Grave

Author Affiliations
  • 1Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
JAMA Intern Med. Published online May 20, 2019. doi:10.1001/jamainternmed.2019.0300

Elder abuse is defined by the Centers for Disease Control and Prevention as “an intentional act, or failure to act, by a caregiver or another person in a relationship involving an expectation of trust that causes or creates a risk of harm to an older adult.”1 Elder abuse has striking similarities to child abuse in that it occurs in the context of a fiduciary relationship, where there is an expectation of care, and includes a range of adverse experiences such as physical abuse, sexual abuse, emotional abuse, neglect, and financial abuse or exploitation. According to the Centers for Disease Control and Prevention, 1 in 10 adults older than 60 years who lives at home experiences elder abuse.2 The prevalence is much higher for older adults who live in institutional settings. This means that an estimated 5 million adults are currently experiencing elder abuse. Given changing population demographics, this number is expected to double by 2060,3 assuming the prevalence of elder abuse remains stable. However, emerging evidence suggests that elder abuse is on the rise; a recent World Health Organization study found that 16% of adults older than 60 years reported experiencing at least one form of elder abuse.4 In contrast to child maltreatment, which has received much needed focused attention from both researchers and policymakers in the past decade, elder abuse is a neglected area of investigation. Thus, little is known about what puts some persons at risk for elder abuse and, therefore, there is little to inform prevention.

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