title: Indicators of elder abuse: a crossnational comparison of psychiatric morbidity and other determinants in the Ad-HOC study.
abstract: OBJECTIVE
  The objective of this study was to determine crossnationally the prevalence of indicators of elder abuse and their relationship to putative risk factors, particularly depression, dementia, and lack of service provision.
  
  
  METHODS
  Nearly 4,000 people aged 65+ receiving health or social community services in 11 European countries were interviewed using the minimum dataset homecare (MDS-HC) interview, which includes an abuse screen used previously in elder abuse studies and questions about demographic, physical, psychiatric, cognitive, and service factors.
  
  
  RESULTS
  One hundred seventy-nine (4.6%) people assessed had at least one indicator of abuse. The proportion screening positive increased with severity of cognitive impairment, presence of depression, delusions, pressure ulcers, actively resisting care, less informal care, expressed conflict with family or friends, or living in Italy or Germany, but not with having a known psychiatric diagnosis.
  
  
  CONCLUSIONS
  Severity of cognitive impairment, depression, and delusions predicted screening positive for abuse in older adults, but having a known psychiatric diagnosis did not, indicating that screening for psychiatric morbidity might be rational strategies to combat elder abuse. People in Italy and Germany were most likely to screen positive for indicators of abuse, and the authors suggest that this might relate to higher levels of dependency in the participants looked after at home in these countries as a result of cultural and service provision differences.
authors.affiliation: Camden and Islington Mental Health and Social Care Trust, Department of Mental Health Sciences, University College London, Archway Campus, Holborn Union Building, Highgate Hill, London, United Kingdom.
authors.forename: Claudia
authors.initials: C
authors.lastname: Cooper
authors.forename: Cornelius
authors.initials: C
authors.lastname: Katona
authors.forename: Harriet
authors.initials: H
authors.lastname: Finne-Soveri
authors.forename: Eva
authors.initials: E
authors.lastname: Topinková
authors.forename: G Iain
authors.initials: GI
authors.lastname: Carpenter
authors.forename: Gill
authors.initials: G
authors.lastname: Livingston
mesh_terms: D000368:Aged; D003156:Community Mental Health Services / Q000706:statistics & numerical data; D003431:Cross-Cultural Comparison; D018153:Czech Republic / Q000453:epidemiology; D003702:Delusions / Q000175:diagnosis / Q000453:epidemiology*; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D004552:Elder Abuse / Q000175:diagnosis / Q000706:statistics & numerical data*; D005163:Factor Analysis, Statistical; D005260:Female; D005602:France / Q000453:epidemiology; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods; D009426:Netherlands / Q000453:epidemiology; D003668:Pressure Ulcer / Q000453:epidemiology; D015995:Prevalence; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology