Elder abuse

Last reviewed: 31 Dec 2022
Last updated: 12 Jan 2022



History and exam

Key diagnostic factors

  • presence of risk factors
More key diagnostic factors

Other diagnostic factors

  • self-report
  • inconsistent history
  • agitated state
  • social isolation
  • physical injuries
  • malnutrition and volume depletion
  • improper medicine use
  • substance abuse
  • carer dominance
  • pressure ulcers
  • shabby appearance
  • genital bleed or wound
Other diagnostic factors

Risk factors

  • age >75 years
  • cognitive impairment
  • dependence on a carer for personal care
  • depression or other mental illness in the carer
  • substance abuse by the older person or the carer
  • financial dependence of the carer on the older adult
More risk factors

Diagnostic investigations

1st investigations to order

  • FBC
  • platelet function studies
  • basic metabolic profile (including urea and creatinine)
  • clinical photograph
  • x-rays
More 1st investigations to order

Investigations to consider

  • CT head
  • CT abdomen
  • serum levels of relevant medicines
  • toxicology screen (urine and blood)
More investigations to consider

Treatment algorithm


suspected elder abuse


confirmed elder abuse



Josephine P. Gomes, MD

Associate Professor

Department of Family and Geriatric Medicine

School of Medicine

University of Louisville




JPG declares that she has no competing interests.


Dr Josephine P. Gomes would like to gratefully acknowledge Professor James O'Brien, Dr Angela R. Wetherton, and Dr Senthil R. Meenrajan, previous contributors to this topic. ARW and SRM declare that they have no competing interests.


JGOB, ARW, and SRM declared that they had no competing interests.

Peer reviewers

Kay Mitchell, MD, MS, FACP

Assistant Professor

Mayo Medical School




KM has been paid as a speaker at the American College of Physicians annual meeting. KM has also been paid for consultation for the physician excellence program.

Cari Levy, MD

Assistant Professor of Medicine

University of Colorado School of Medicine and the Denver Veterans Affairs Medical Center




CL declares that she has no competing interests.

Desmond O'Neill, MA, MD, FRCPI, AGSF, FRCP(Glasg)

Associate Professor of Medical Gerontology

Department of Medical Gerontology

School of Medicine

Trinity College Dublin




DON declares that he has no competing interests.

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