Study Suggests Radiologists Be Trained to Detect Elder Abuse

Although radiologists are highly trained to detect cases of potential child abuse, very few have received either formal or informal instruction in detecting elder abuse.

And while spotting abuse in older people tends to be a much more complicated task, many radiologists express a desire for more training in this area, according to a new study.

“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?” said Dr. Tony Rosen, study coauthor and emergency physician at Weill Cornell Medical College, New York.

Rosen notes that one important obstacle to this training, however, is the lack of research examining injury patterns in elder abuse. And making the situation even more complicated is that it is much more difficult overall to detect abuse in elderly people than it is in children.

He said that, “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 nursing home.”

Of the 19 diagnostic radiologists interviewed as part of this research, only two reported receiving formal or informal training in elder abuse detection, and all of the participants believed they had most likely missed cases of elder abuse. Despite this, all diagnostic radiologists interviewed expressed a desire for additional training in the area.

“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, said Dr. Kieran Murphy, study coauthor and radiology professor at the University of Toronto, Ontario.

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.

As many as 10 percent of older U.S. adults experience elder mistreatment each year, and evidence suggests that victims have dramatically increased mortality and morbidity.

The study is published in the American Journal of Roentgenology (AJR) and was supported by the National Institute on Aging.

Source: American Roentgen Ray Society