title: Types of abuse and risk factors associated with elder abuse.
abstract: BACKGROUND
  Detecting elder abuse is challenging because it is a taboo, and many cases remain unreported. This study aimed to identify types of elder abuse and to investigate its associated risk factors.
  
  
  METHODS
  Retrospective analyses of 903 dossiers created at an Independent Complaints Authority for Old Age in the Canton of Zurich, Switzerland, from January 1, 2008 to October 31, 2012. Characteristics of victims and perpetrators, types of abuse, and associated risk factors related to the victim or the perpetrator were assessed. Bi- and multivariate analysis were used to identify abuse and neglect determinants.
  
  
  RESULTS
  A total of 150 cases reflected at least one form of elder abuse or neglect; 104 cases were categorised as abuse with at least one type of abuse (overall 135 mentions), 46 cases were categorised as neglect (active or passive). Psychological abuse was the most reported form (47%), followed by financial (35%), physical (30%) and anticonstitutional abuse (18%). In 81% of the 150 cases at least two risk factors existed. In 13% no associated risk factor could be identified. Compared with neglect, elders with abuse were less likely to be a nursing home resident than living at home (odds ratio [OR] 0.02, 95% confidence interval [CI] 0.00-0.19). In addition, they were more likely to be cohabiting with their perpetrators (OR 18.01, 95% CI 4.43-73.19).
  
  
  CONCLUSIONS
  For the majority of the reported elder abuse cases at least two associated risk factors could be identified. Knowledge about these red flags and a multifaceted strategy are needed to identify and prevent elder abuse.
authors.affiliation: Institute of Primary Care, University of Zurich, University Hospital Zurich, Switzerland.
authors.forename: Lacher
authors.initials: L
authors.lastname: Simone
authors.affiliation: Head of expert committee Independent Complaints Authority for Old Age in the Canton of Zurich, Switzerland.
authors.forename: Albert
authors.initials: A
authors.lastname: Wettstein
authors.affiliation: Institute of Primary Care, University of Zurich, University Hospital Zurich, Switzerland.
authors.forename: Oliver
authors.initials: O
authors.lastname: Senn
authors.affiliation: Institute of Primary Care, University of Zurich, University Hospital Zurich, Switzerland.
authors.forename: Thomas
authors.initials: T
authors.lastname: Rosemann
authors.affiliation: Institute of Primary Care, University of Zurich, University Hospital Zurich, Switzerland; Department of Internal Medicine, Kantonsspital Winterthur, Switzerland.
authors.forename: Susann
authors.initials: S
authors.lastname: Hasler
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000453:epidemiology*; D004552:Elder Abuse / Q000706:statistics & numerical data*; D005260:Female; D006301:Health Services Needs and Demand; D045809:Human Rights Abuses / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009735:Nursing Homes; D000066550:Physical Abuse / Q000706:statistics & numerical data*; D015995:Prevalence; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D012934:Social Isolation; D013557:Switzerland / Q000453:epidemiology; D014505:Urban Population