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Background
Elder abuse is widespread, and may cut across social, economic, religious and cultural groups. A review of 49 studies on elder abuse (Cooper et al. , 2008) reported prevalence rates between 3.2-55 per cent depending on various factors (e.g. abuse type). More recently, a UK survey of abuse against persons aged 66 years and older during the past year (O'Keeffe et al. , 2007) found rates of 1.1 per cent for neglect, of 0.6 per cent for financial abuse, of 0.4 per cent for psychological and physical abuse (each) and of 0.2 per cent for sexual abuse. In Israel, a study of abuse towards Jewish and Arab adults aged 65 years and older during the past 12 months observed rates of total abuse/neglect of 35.2 and 34 per cent, respectively (Lowenstein et al. , 2009). A study from the USA among persons aged 60 years or older revealed that the one-year prevalence of sexual abuse was 0.6 per cent, of physical abuse 1.6 per cent, of emotional abuse 4.6 per cent, of financial abuse 5.2 per cent and of potential neglect 5.1 per cent (Acierno et al. , 2010). A European survey (Macassa et al. , 2013) reported psychological abuse rates between 10.4 and 29.7 per cent depending on the country[1]. As above indicated there is great variation in prevalence rates between the studies, which may be due to differences in samples and the operational definition of abuse.
Abuse may significantly add to the health, social and financial strains of older age. Studies with different samples (e.g. community) indicate that elder abuse may be associated with various negative outcomes such as impairments, shorter survival rates, depression, posttraumatic stress disorder (PTSD) or low social support (e.g. Acierno et al. , 2010; Comijs et al. , 1999; Dong, 2005; Dong et al. , 2010; Fulmer, 2002; Kim et al. , 2005; Lachs et al. , 1997, 1998; O'Keeffe et al. , 2007; Podnieks, 1992; Wolf, 1997; Wu et al. , 2012; Yan and Tang, 2001). Thus, from being considered a "social welfare issue and a problem of ageing" (World Health Organization (WHO), 2002), abuse against older persons is actually a major public health issue.
In spite of a mounting number of studies on elder abuse, data...