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A substantial number of U.S. older persons — between 2 and 10 percent of the elderly population — are physically or mentally abused, and mistreated seniors are three times more likely to die within three years than those who are not abused, report two Cornell University gerontologists in the October 2 issue of the medical journal The Lancet.

In a review article of more than 50 published studies, Dr. Mark S. Lachs — professor of medicine at Weill Cornell Medical College and attending physician at New York-Presbyterian Hospital/Weill Cornell Medical Center in New York City — and co-author Dr. Karl Pillemer — professor of human development in the College of Human Ecology at Cornell University in Ithaca — detail risk factors, clinical manifestations, diagnosis, and treatment of elder abuse.

They find that elder abuse is often unrecognized and under-treated due to its high prevalence combined with lack of time and resources, and inability to recognize the problem. The difficulty in making an accurate diagnosis, given the high risk of false positives and false negatives, is also highlighted. The result is "a heightened risk of physical and mental harm, and even death," the two authors note.

The article calls for a multidisciplinary team approach — including physicians, nurses, social workers, advocacy organizations, and the police — to assess the situation and develop solutions that are tailored to the individual victim's needs and problems. The authors also call for future research on the creation of practical screening and intervention techniques.

"Family violence directly affects quality of life, and removal of a patient from an abusive situation is one of the most gratifying experiences for physicians and other health-care professionals," says Dr. Lachs.

Commenting on the article's findings, an accompanying Lancet editorial states: "Elderly people should not be seen as marginalized victims in society but as fully participating and valuable citizens. Anything less is inhumane and unsustainable."

The research was supported, in part, by a National Institute on Aging Mentoring Award in Patient-Oriented Research in Aging, and an Edward R. Roybal Center grant, also from the National Institute on Aging.