Shugarman et al identified risk factors associated with abuse in an elderly person. These factors can help identify a person who requires closer monitoring or additional interventions. The authors are from RAND Corporation, University of Michigan, University of Massachusetts and the Hebrew Rehabilitation Center for the Aged in Boston.

NOTE: The study appears to cover both emotional and physical abuse. Data on financial abuse was not available.


Risk factors associated with abuse in a logistic regression model:

(1) problems with short term memory

(2) one or more psychiatric diagnoses

(3) alcohol abuse

(4) not at ease when interacting with others

(5) presence of conflict with family or friends

(6) feels lonely

(7) support system brittle


Risk Factor

Odds Ratio

95% CI

short term memory problem


1.47 - 5.69

psychiatric diagnosis


1.17 - 4.89

alcohol abuse


2.63 - 29.3

not at ease in interacting with others


1.17 - 5.36

conflict with family or friends


1.21 - 4.26

feels lonely


1.25 - 4.48

brittle support system


1.54 - 8.13


risk index =

= SUM(risk factors present)



• minimum risk index: 0

• maximum risk index: 7

• An index >= 3 indicates an elderly person who may be at increased risk for abuse.



• The sensitivity at a score of >= 3 is about 93% with a specificity of 40%.

• Weighting brittle support and ethanol abuse more might help improve the index.



• The risk factors are nonspecific and the index is only useful for screening.

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