Mechanisms and weapons in physical elder abuse injuries: Findings from legally adjudicated cases

• Published in: Injury 2023-08, Vol.54 (8), p.110845-110845, Article 110845
• Main Authors: Rosen, Tony, Rippon, Brady, Elman, Alyssa, Gogia, Kriti, Chansakul, Aisara, Chang, E-Shien, Hancock, David W., Bloemen, Elizabeth M., Clark, Sunday, LoFaso, Veronica M.
• Format: Article
• Language: English
• Subjects: Aged; Child; Contusions - epidemiology; Crime Victims; Elder Abuse; Female; Humans; Injury patterns; Mechanisms of injury; Neck; Physical Abuse
• ISSN: 0020-1383; 1879-0267; 1879-0267
• DOI: 10.1016/j.injury.2023.110845

•Recognizing physical elder abuse injuries among purportedly unintentional injuries is a critical role for trauma providers, and understanding injury patterns may be helpful.•Victims of physical elder abuse with injuries are more commonly assaulted with an abuser's body part than with an object.•When an object is used, it is more commonly a household object than a weapon.•Mechanisms, weapons, characteristics of the older adults, and surrounding circumstances each impact the injury patterns found. Elder abuse is common, but many characteristics have not been well-described, including injury mechanisms and weapons in physical abuse. Better understanding of these may improve identification of elder abuse among purportedly unintentional injuries. Our goal was to describe mechanisms of injury and weapons used and their relation to injury patterns. We partnered with District Attorney's offices in 3 counties and systematically examined medical, police, and legal records from 164 successfully prosecuted physical abuse cases of victims aged ≥60 from 2001 to 2014. Victims sustained 680 injuries (mean 4.1, median 2.0, range 1–35). Most common mechanisms were: blunt assault with hand/fist (44.5%), push/shove, fall during altercation (27.4%), and blunt assault with object (15.2%). Perpetrators more commonly used body parts as weapons (72.6%) than objects (23.8%). Most commonly used body parts were: open hands (55.5% of victims sustaining injuries from body parts), closed fists (53.8%), and feet (16.0%). Most commonly used objects were: knives (35.9% of victims sustaining injuries from objects) and telephones (10.3%). The most frequent mechanism/injury location pair was maxillofacial/dental/neck injury by blunt assault with hand/fist (20.0% of all injuries). The most frequent mechanism/injury type pair was bruising by blunt assault with hand/fist (15.1% of all injuries). Blunt assault with hand/fist injury was positively associated with victim female sex (OR: 2.27, CI: [1.08 – 4.95]; p = 0.031), while blunt assault with object mechanisms was inversely associated with victim female sex (OR: 0.32, CI: [0.12 - 0.81]; p = 0.017). Physical elder abuse victims are more commonly assaulted with an abuser's body part than an object, and the mechanisms and weapons used impact patterns of injury.