Elder Abuse and The Multiple Hit Hypothesis

Using data from Kentucky's The Worker Information System (TWIST), which houses 30 years of data on Child Protective Services (CPS) cases as well as Adult Protective Services (APS) cases, we found characteristics of abused elders: female, Caucasian, approximately 75 years of age, problems with cognitive capacity, and needing assistance with at least one Activity of Daily Living. These characteristics are common among individuals not victims, thus we hypothesize that elder abuse is better modeled by a multiple-hit, rather than a single-hit hypothesis. The multiple hit hypothesis is valuable in explaining a variety of biological-based conditions in which a single factor is not sufficient to cause cellular dysfunction. Testing this hypothesis we examine common societal factors in cases involving children under 18 who entered CPS and then APS. We expect that within this cohort, multiple factors converge: being female, having cognitive impairment, and needing assistance with at least one ADL. Further, in cases in which two or more socially related ‘hits' are not observed, another environmental or biological factor is involved. To determine potential biological ‘hits' a thorough examination of individual reports for linkages to other family members involved in individual reports as well as those of other family members reported as a unique case within TWIST are used to examine familial relationships related to age of first report in CPH, gender, family relationship of victim to perpetrator and to other victims, victim physical and mental functioning, socioeconomic factors, living environment, settings of abuse, and types and frequency of abuse.