{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T15:33:24Z","timestamp":1767713604287,"version":"build-2065373602"},"reference-count":57,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T00:00:00Z","timestamp":1691712000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Older adult maltreatment (OAM) is a global problem that has attracted increasing attention due to the ageing population and its severe impact on victim health. Thus, this study aims to analyse the prevalence of certain health conditions in people \u2265 60 years old whom physicians from a local healthcare unit suspected to be victims of maltreatment. The specific objectives are to determine the prevalence rates of health-related risk factors, traumatic injuries and intoxications, mental disorders, and physical disorders. We conducted a real-world, retrospective, observational, and cross-sectional study based on secondary data analyses of electronic health records and healthcare registers of patients at the Local Healthcare Unit of Matosinhos (2001\u20132021). Information was obtained based on codes from the International Classification of Diseases, codes from the International Classification of Primary Care, and clinical notes (according to previously defined keywords). We identified 3092 suspected victims of OAM, representing 4.5% of the total population analysed. This prevalence is lower than the known rates. We also found that some health risk factors, traumatic injuries and intoxications, mental health disorders, and physical disorders presented higher rates in the suspected victims than among the total population. In this age group, we cannot assume that these health problems are only related to a possible current victimisation process; they could also be associated with adverse childhood experiences or intimate partner violence, among other forms of violence, all of which can lead to cumulative effects on the victim\u2019s health. This evidence increases healthcare providers\u2019 responsibility in detecting and reporting all cases of suspected maltreatment.<\/jats:p>","DOI":"10.3390\/jcm12165247","type":"journal-article","created":{"date-parts":[[2023,8,11]],"date-time":"2023-08-11T12:10:23Z","timestamp":1691755823000},"page":"5247","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Health Conditions in Older Adults Suspected of Being Maltreated: A 20-Year Real-World Study"],"prefix":"10.3390","volume":"12","author":[{"given":"Hugo","family":"Gra\u00e7a","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"}]},{"given":"Sofia Lalanda","family":"Fraz\u00e3o","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"National Institute of Legal Medicine and Forensic Sciences, Largo da S\u00e9 Nova, 3000-231 Coimbra, Portugal"},{"name":"Abel Salazar Biomedical Sciences Institute, University of Porto, 4050-313 Porto, Portugal"}]},{"given":"Teresa","family":"Magalh\u00e3es","sequence":"additional","affiliation":[{"name":"MTG Research and Development Lab, 4200-604 Porto, Portugal"},{"name":"Center for Health Technology and Services Research (CINTESIS@RISE), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Toxicology Research Unit, University Institute of Health Sciences, Advanced Polytechnic and University Cooperative (CESPU), CRL, 4585-116 Gandra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8385-8293","authenticated-orcid":false,"given":"Paulo","family":"Vieira-Pinto","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"FOREN\u2014Forensic Science Experts, 1400-136 Lisboa, Portugal"},{"name":"Faculty of Human and Social Sciences, University Fernando Pessoa (FCHS-UFP), 4249-004 Porto, Portugal"}]},{"given":"Joana Costa","family":"Gomes","sequence":"additional","affiliation":[{"name":"Abel Salazar Biomedical Sciences Institute, University of Porto, 4050-313 Porto, Portugal"},{"name":"USF Caravela, Local Healthcare Unit of Matosinhos, Rua da Lagoa, 4460-352 Senhora da Hora, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0998-6000","authenticated-orcid":false,"given":"Tiago","family":"Taveira-Gomes","sequence":"additional","affiliation":[{"name":"MTG Research and Development Lab, 4200-604 Porto, Portugal"},{"name":"Center for Health Technology and Services Research (CINTESIS@RISE), Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal"},{"name":"Faculty of Health Sciences, University Fernando Pessoa (FCS-UFP), 4249-004 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,11]]},"reference":[{"key":"ref_1","unstructured":"Sethi, D., Wood, S., Mitis, F., Bellis, M., Penhale, B., Marmolejo, I.I., Lowenstein, A., Manthorpe, G., and K\u00e4rki, F.U. (2011). European Report on Preventing Elder Maltreatment."},{"key":"ref_2","unstructured":"World Health Organization, Ageing, Life Course Unit, Universit\u00e9 de Gen\u00e8ve, and Centre Interfacultaire de G\u00e9rontologie (2008). A Global Response to Elder Abuse and Neglect: Building Primary Health Care Capacity to Deal with the Problem World-Wide: Main Report."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S194","DOI":"10.1093\/geront\/gnw004","article-title":"Elder Abuse: Global Situation, Risk Factors, and Prevention Strategies","volume":"56","author":"Pillemer","year":"2016","journal-title":"Gerontologist"},{"key":"ref_4","unstructured":"NCEA (2023, January 07). Types of Abuse, Available online: https:\/\/ncea.acl.gov\/Suspect-Abuse\/Abuse-Types.aspx#neglect."},{"key":"ref_5","unstructured":"Hall, J.E., Karch, D.L., and Crosby, A. (2016). Uniform Definitions and Recommended Core Data Elements for Use in Elder Abuse Surveillance. Version 1.0."},{"key":"ref_6","unstructured":"Perel-Levin, S., World Health Organization, and Ageing, Life Course Unit (2008). Discussing Screening for Elder Abuse at Primary Health Care Level by Silvia Perel-Levin."},{"key":"ref_7","unstructured":"He, W., Goodkind, D., and Kowal, P.R. (2016). An Aging World: 2015."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e147","DOI":"10.1016\/S2214-109X(17)30006-2","article-title":"Elder abuse prevalence in community settings: A systematic review and meta-analysis","volume":"5","author":"Yon","year":"2017","journal-title":"Lancet Glob. Health"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.carj.2012.12.001","article-title":"A literature review of findings in physical elder abuse","volume":"64","author":"Murphy","year":"2013","journal-title":"Can. Assoc. Radiol. J."},{"key":"ref_10","unstructured":"Magalhaes, T., and Vieira, D.N. (2013). Agress\u00f5es Sexuais: Interven\u00e7\u00e3o Pericial Integrada, SPECAN."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1001\/jama.2009.1109","article-title":"Elder self-neglect and abuse and mortality risk in a community-dwelling population","volume":"302","author":"Dong","year":"2009","journal-title":"JAMA"},{"key":"ref_12","first-page":"783","article-title":"Improving assistance to elderly victims of violence: Healthcare personnel as a window for opportunity","volume":"37","author":"Tozzo","year":"2021","journal-title":"Acta Med. Mediterr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"17035","DOI":"10.3390\/ijerph192417035","article-title":"Health Outcomes in Women Victims of Intimate Partner Violence: A 20-Year Real-World Study","volume":"19","author":"Magalhaes","year":"2022","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_14","unstructured":"NCEA (2023, January 07). Research, Statistics, and Data: National Center of Lder Abuse, Available online: https:\/\/ncea.acl.gov\/What-We-Do\/Research\/Statistics-and-Data.aspx#_ednref1."},{"key":"ref_15","unstructured":"Podnieks, E., and Thomas, C. (2017). Elder Abuse, Springer."},{"key":"ref_16","unstructured":"Wilkins, N., Tsao, B., Hertz, M., Davis, R., and Klevens, J. (2014). Connecting the Dots: An Overview of the Links Among Multiple Forms of Violence."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Asyraf, M., Dunne, M.P., Hairi, N.N., Mohd Hairi, F., Radzali, N., and Wan Yuen, C. (2021). The association between elder abuse and childhood adversity: A study of older adults in Malaysia. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0254717"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.jflm.2014.09.003","article-title":"Domestic violence against elderly with disability","volume":"28","author":"Silva","year":"2014","journal-title":"J. Forensic Leg. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"693420","DOI":"10.3389\/fpsyg.2021.693420","article-title":"When Problems Only Get Bigger: The Impact of Adverse Childhood Experience on Adult Health","volume":"12","author":"Novais","year":"2021","journal-title":"Front. Psychol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2353","DOI":"10.3390\/jcm12062353","article-title":"Are There Any Differences in Road Traffic Injury Outcomes between Older and Younger Adults? Setting the Grounds for Posttraumatic Senior Personal Injury Assessment Guidelines","volume":"12","author":"Santos","year":"2023","journal-title":"J. Clin. Med."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Krug, E.G., Dahlberg, L.L., Mercy, J.A., Zwi, A.B., Lozano, R., and World Health Organization (2002). World Report on Violence and Health.","DOI":"10.1016\/S0140-6736(02)11133-0"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1016\/j.annemergmed.2016.01.037","article-title":"Identifying Elder Abuse in the Emergency Department: Toward a Multidisciplinary Team-Based Approach","volume":"68","author":"Rosen","year":"2016","journal-title":"Ann. Emerg. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1080\/08946566.2020.1768997","article-title":"Screening for elder mistreatment in emergency departments: Current progress and recommendations for next steps","volume":"32","author":"Rosen","year":"2020","journal-title":"J. Elder Abus. Negl."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"687","DOI":"10.20344\/amp.6706","article-title":"Detection and Intervention Strategies by Primary Health Care Professionals in Suspected Elder Abuse","volume":"28","author":"Ferreira","year":"2015","journal-title":"Acta Med. Port."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1046\/j.1525-1497.2002.10309.x","article-title":"Managed care, primary care, and the patient-practitioner relationship","volume":"17","author":"Forrest","year":"2002","journal-title":"J. Gen. Intern. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1080\/20961790.2019.1641954","article-title":"Epigenomic mediation after adverse childhood experiences: A systematic review and meta-analysis","volume":"6","author":"Neves","year":"2021","journal-title":"Forensic Sci. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1007\/s10964-014-0097-8","article-title":"Exposure to violence predicting cortisol response during adolescence and early adulthood: Understanding moderating factors","volume":"43","author":"Aiyer","year":"2014","journal-title":"J. Youth Adolesc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/S0091-7435(03)00123-3","article-title":"The impact of adverse childhood experiences on health problems: Evidence from four birth cohorts dating back to 1900","volume":"37","author":"Dube","year":"2003","journal-title":"Prev. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1007\/s00406-005-0624-4","article-title":"The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology","volume":"256","author":"Anda","year":"2006","journal-title":"Eur. Arch. Psychiatry Clin. Neurosci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"101339","DOI":"10.1016\/j.avb.2019.101339","article-title":"Risk factors for elder abuse and neglect: A review of the literature","volume":"50","author":"Storey","year":"2020","journal-title":"Aggress. Violent Behav."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1093\/ageing\/afs195","article-title":"Elder abuse: A systematic review of risk factors in community-dwelling elders","volume":"42","author":"Johannesen","year":"2013","journal-title":"Age Ageing"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1016\/j.jagp.2021.01.007","article-title":"High Prevalence of Elder Abuse During the COVID-19 Pandemic: Risk and Resilience Factors","volume":"29","author":"Chang","year":"2021","journal-title":"Am. J. Geriatr. Psychiatry"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1007\/s00391-021-01945-0","article-title":"Elder abuse in the oldest old: Prevalence, risk factors and consequences","volume":"54","author":"Brijoux","year":"2021","journal-title":"Z. Gerontol. Geriatr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1177\/1078390306297519","article-title":"Elder Mistreatment: Risk, Vulnerability, and Early Mortality","volume":"12","author":"Baker","year":"2016","journal-title":"J. Am. Psychiatr. Nurses Assoc."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.jflm.2015.09.002","article-title":"Physical abuse against elderly persons in institutional settings","volume":"36","author":"Correia","year":"2015","journal-title":"J. Forensic Leg. Med."},{"key":"ref_36","first-page":"453","article-title":"Detecting elder abuse and neglect: Assessment and intervention","volume":"89","author":"Hoover","year":"2014","journal-title":"Am. Fam. Physician"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1016\/S0140-6736(02)08336-8","article-title":"Health consequences of intimate partner violence","volume":"359","author":"Campbell","year":"2002","journal-title":"Lancet"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1136\/emj.2005.031260","article-title":"The association between domestic violence and self harm in emergency medicine patients","volume":"23","author":"Boyle","year":"2006","journal-title":"Emerg. Med. J."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Dong, X. (2017). Elder Abuse: Research, Practice and Policy, Springer International Publishing.","DOI":"10.1007\/978-3-319-47504-2"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2163","DOI":"10.1111\/j.1532-5415.2011.03653.x","article-title":"Self-neglect and elder abuse: Related phenomena?","volume":"59","author":"Bartley","year":"2011","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1002\/ams2.403","article-title":"Intentional or unintentional drug poisoning in elderly people: Retrospective observational study in a tertiary care hospital in Japan","volume":"6","author":"Haoka","year":"2019","journal-title":"Acute Med. Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1177\/1524838017692798","article-title":"Consequences of Elder Abuse and Neglect: A Systematic Review of Observational Studies","volume":"20","author":"Yunus","year":"2019","journal-title":"Trauma Violence Abus."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1159\/000341652","article-title":"Elder abuse and psychological well-being: A systematic review and implications for research and policy\u2014A mini review","volume":"59","author":"Dong","year":"2013","journal-title":"Gerontology"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"2177","DOI":"10.1111\/jocn.13490","article-title":"Older women, intimate partner violence and mental health: A consideration of the particular issues for health and healthcare practice","volume":"26","author":"McGarry","year":"2017","journal-title":"J. Clin. Nurs."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1159\/000437420","article-title":"Association between Elder Mistreatment and Suicidal Ideation among Community-Dwelling Chinese Older Adults in the USA","volume":"62","author":"Dong","year":"2015","journal-title":"Gerontology"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1111\/j.1547-5069.2006.00090.x","article-title":"Outcome from serious injury in older adults","volume":"38","author":"Jacoby","year":"2006","journal-title":"J. Nurs. Scholarsh."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1097\/JTN.0000000000000215","article-title":"Delta Alerts: Changing Outcomes in Geriatric Trauma","volume":"23","author":"Wiles","year":"2016","journal-title":"J. Trauma Nurs."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1108\/JAP-08-2013-0034","article-title":"The impact of psychological abuse on somatic symptoms: A study of older persons aged 60\u201384 years","volume":"16","author":"Viitasara","year":"2014","journal-title":"J. Adult Prot."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1622","DOI":"10.1377\/hlthaff.2019.00480","article-title":"The Effects of Violence on Health","volume":"38","author":"Rivara","year":"2019","journal-title":"Health Aff."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1214","DOI":"10.1111\/jgs.13454","article-title":"Elder Abuse: Systematic Review and Implications for Practice","volume":"63","author":"Dong","year":"2015","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"814684","DOI":"10.3389\/fnins.2022.814684","article-title":"Traumatic Brain Injury Is Associated with Both Hemorrhagic Stroke and Ischemic Stroke: A Systematic Review and Meta-Analysis","volume":"16","author":"Qu","year":"2022","journal-title":"Front. Neurosci."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Costello, K., and Greenwald, B.D. (2022). Update on Domestic Violence and Traumatic Brain Injury: A Narrative Review. Brain Sci., 12.","DOI":"10.3390\/brainsci12010122"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1080\/08946566.2022.2039338","article-title":"Abuse among Portuguese older people at a time of economic crisis recovery: Findings from the Harmed study","volume":"34","author":"Dias","year":"2022","journal-title":"J. Elder Abus. Negl."},{"key":"ref_54","unstructured":"Eurostat (2023, January 22). Half of EU\u2019s Population Older Than 44.4 Years in 2022. Europa.eu, Available online: https:\/\/ec.europa.eu\/eurostat\/web\/products-eurostat-news\/w\/ddn-20230222-1."},{"key":"ref_55","first-page":"e14375","article-title":"Elder Abuse: A Comprehensive Overview and Physician-Associated Challenges","volume":"13","author":"Patel","year":"2021","journal-title":"Cureus"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1080\/08946566.2021.2014378","article-title":"Factors associated with health care providers speaking with older patients about being subjected to abuse","volume":"34","author":"Motamedi","year":"2022","journal-title":"J. Elder Abus. Negl."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1080\/08946566.2019.1588182","article-title":"Disclosure among victims of elder abuse in healthcare settings: A missing piece in the overall effort toward detection","volume":"31","author":"Truong","year":"2019","journal-title":"J. Elder Abus. Negl."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/16\/5247\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:31:41Z","timestamp":1760128301000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/16\/5247"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,11]]},"references-count":57,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2023,8]]}},"alternative-id":["jcm12165247"],"URL":"https:\/\/doi.org\/10.3390\/jcm12165247","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2023,8,11]]}}}