UMEM Educational Pearls

Category: Orthopedics

Title: Physical injury patterns associated with physical elder abuse

Keywords: Elder abuse, bruising, trauma (PubMed Search)

Posted: 9/26/2020 by Brian Corwell, MD (Updated: 4/26/2024)
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Physical injury patterns associated with physical elder abuse

Elder abuse is both common and underrecognized

Between 5 and 10% of US older adults are victims of elder abuse annually

For many older adults, contact with a health care provider may represent their only contact outside the home

Differentiating physical elder abuse from unintentional trauma can be very difficult

A recent study compared these two groups with a case-control design

Study cases: 100 successfully prosecuted physical elder abuse cases from a single urban ED

Physical abuse victims were more likely to have:

Bruising (78% vs. 54%)

Injuries to maxillofacial, dental or neck region (67% vs. 28%)

Particularly the LEFT side

Neck injuries 6x more common is assault

Ear injuries occurred in assault but not in falls

Absence of fracture (8% vs. 22%)

Less likely to have lower extremity injuries (9% vs. 41%)

22% of victims had no visible injuries

Most common mechanism assault with hands or fists and pushing or shoving causing a fall

Take home: Consider elder abuse especially in cases of the above red flags

References

Rosen T, et al. Identifying Injury Patterns Associated With Physical Elder Abuse: Analysis of Legally Adjudicated Cases. Ann Emerg Med. 2020 Sep;76(3):266-276.