{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T18:16:40Z","timestamp":1783016200308,"version":"3.54.6"},"reference-count":71,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Geriatrics"],"abstract":"<jats:p>Background\/Objectives: Elder abuse remains a significantly underreported public health issue. The study examines how elder abuse is detected through a passive, suspicion-based case-finding pathway in an Italian university hospital emergency department (ED) and what the findings imply for improving systematic screening. Methods: This retrospective study analyzed elder abuse cases accessed at Careggi University Hospital ED (Florence, Italy) from 2017 to 2022. Eligible patients were aged \u226565 years and had suspected or confirmed elder abuse identified through Rosa Code protocol activation, abuse-related ICD-10 codes, and forensic consultation records. Two investigators independently reviewed eligible charts using predefined inclusion criteria and a standardized data-extraction form. Missing or unclear documentation was quantified descriptively, and no imputation was performed. Results: Sixty-seven elder abuse cases were identified during the six-year period, corresponding to a reported detection rate of 0.8% among the records screened for this study (mean: 11.2 cases\/year). All eligible cases were captured through Rosa Code activation; ICD-10 and forensic-record searches did not identify additional cases. The majority of victims were women (76.1%), with a mean age of 75.5 years, and 76.1% had documented comorbidities. Physical abuse was the most common form (61.2%), predominantly perpetrated by family members (93.8%) within the victim\u2019s home (64.2%). Head and neck injuries were most frequent (43.3%). A notable 50% decline in reported cases occurred during the COVID-19 pandemic. Despite law enforcement notification in 78% of cases, 65.7% of patients were discharged home. Conclusions: The study\u2019s detection rate (&lt;1%) falls critically short of international benchmarks (3\u20135%), underscoring urgent need for systematic screening using validated tools and staff training and multidisciplinary safeguarding pathways in Italian emergency departments.<\/jats:p>","DOI":"10.3390\/geriatrics11040079","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T15:52:24Z","timestamp":1783007544000},"page":"79","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Detecting Elder Abuse in an Italian Emergency Department: A Six-Year Retrospective Study and Implications for Systematic Screening"],"prefix":"10.3390","volume":"11","author":[{"given":"Martina","family":"Focardi","sequence":"first","affiliation":[{"name":"Multidisciplinary Research Laboratory in Forensic Sciences (CRIME-LAB), Department of Health Sciences, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"D\u2019Onofrio","sequence":"additional","affiliation":[{"name":"Hospital Management Rosa Code Unit, AOUC-Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Carnevali","sequence":"additional","affiliation":[{"name":"Hospital Management Rosa Code Unit, AOUC-Careggi University Hospital, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca Romana","family":"Ermini","sequence":"additional","affiliation":[{"name":"Santa Maria Nuova Hospital, 50122 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Orlandi","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Section of Forensic Medical Sciences, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5407-2160","authenticated-orcid":false,"given":"Ilenia","family":"Bianchi","sequence":"additional","affiliation":[{"name":"Laboratory of Personal Identification and Forensic Morphology, Department of Health Sciences, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Gualco","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Section of Forensic Medical Sciences, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6124-3298","authenticated-orcid":false,"given":"Vilma","family":"Pinchi","sequence":"additional","affiliation":[{"name":"Laboratory of Personal Identification and Forensic Morphology, Department of Health Sciences, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9392-9729","authenticated-orcid":false,"given":"Beatrice","family":"Defraia","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Section of Forensic Medical Sciences, University of Florence, 50134 Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (WHO) (2026, March 01). 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