As many as 10% of older United States adults experience elder mistreatment each
year, and evidence suggests that victims have dramatically increased
mortality and morbidity.
Identifying elder abuse can be challenging for radiologists.
Radiologists may be uniquely positioned to identify elder abuse, but
they don't have training or experience in detecting it, revealed a
study published in the December 2016 issue of the American Journal of Roentgenology
‘Geriatric patients, particularly those with acute injuries, commonly undergo radiographic imaging as part of their medical evaluation, so radiologists may be well-positioned to raise suspicion for mistreatment.’
Radiologists play a critical role in child abuse detection by
identifying injury patterns that suggest intentional injury rather than
an accident. Though a potential opportunity exists to make a similar
contribution in elder abuse, it has not yet been a focus of radiology
research, training, or practice.
Of the 19 diagnostic radiologists interviewed as part of this
research, only two reported formal or informal training in elder abuse
detection, and all participants believed they had missed cases of elder
abuse. Despite this, all diagnostic radiologists interviewed reported a
desire for additional training in the subject area.
The study was supported by the National Institute on Aging.
"There's very little research that examines injury patterns or imaging
correlates in elder abuse," said Tony Rosen, study coauthor and
emergency physician at Weill Cornell Medical College, New York.
"Additionally, for various reasons including age-related osteopenia, use
of anticoagulant medications, and the frequency of accidental injuries
from falls, elder abuse is often not easy to spot. Also, while patient
age is often very helpful to radiologists assessing images for potential
child abuse, it is not as useful in older adults because one
81-year-old may be running marathons while another is bed-bound in a
Kieran Murphy, study coauthor and radiology professor at the
University of Toronto, Ontario, emphasized the opportunity for
radiologists to potentially contribute. "Geriatric patients,
particularly those with acute injuries, commonly undergo radiographic
imaging as part of their medical evaluation, so radiologists may be
well-positioned to raise suspicion for mistreatment."
On the basis of these findings, the research team plans to conduct
future studies to define pathognomonic injury patterns and to explore
how to empower radiologists to incorporate detection into their
practice. Rosen said, "Radiologists are a core part of the medical team
in child abuse cases, so why shouldn't they be a core part of the team
in elder abuse?"