Limitations and Conclusions Among the limitations of our study was that we derived all our prevalence estimates and correlates from self-reports of precisely the types of events that are notoriously under- reported in this age group. However, we took
several steps to maximize the likelihood that abuse events would be disclosed. First, and in light of research on younger adults,9 we did not use either open-ended or culturally loaded questions to determine victimization status. Open-ended questions that prompt participants to respond to general queries (e.g., ‘‘Please tell me about any times where people might have treated you badly’’) do not regularly result in descriptionsofassaultevents. Wealsoconducted interviewswhenthe participant wasaloneor was able to speak privately without fear of being overheard, which increased the likelihood of disclosure. Another limitation in our data was the absence of some measure of cognitive func- tioning as a covariate or a risk factor. To control for this variable, we required interviewers to proceed with questioning only if they had no doubt about the ability of respondents to un- derstand and respond to questions. Our data therefore reflect responses of a cognitively in- tact, community-residing subpopulation of older adults; prevalence and risk factors should be considered in that context. Generalization of our results to what may be the group most at-risk for mistreatment, the cognitively im- paired elderly, is not appropriate. For this at-risk group, and particularly for members of this group living in residential settings, alter- native methods are required and will probably resemble the sentinel approach used with children. We did not include individuals who did not have a landline (i.e., those with only cell phones), introducing the potential for bias; however, our data were nationally representa- tive and were weighted by census estimates, increasing the generalizability of our findings. Future research should be directed toward assessing mental and physical health conditions associated with mistreatment of the elderly. Although we have intuitive awareness of the negative effects of abuse of older adults, it is necessary to determine just what forms of abuse, in the context of which risk factors, lead to which negative emotional, functional, and health outcomes.