Geriatric forensics - Part 2 "Prevalence of elder abuse and their potential forensic markers among medical and dental patients"


Khurshid Mattoo
Rishabh Garg
Shalabh Kumar


Context: This study is a continuation of the earlier studies and has been extended to investigate the potential forensic markers of elder abuse. Aims: To determine the prevalence of elder abuse in various outpatient departments (OPDs). To study the associated parameters related to the abuser and the abused. To determine the existence of potential forensic markers of elder abuse. Settings and Design: The subjects were randomly selected from the medical and the dental OPDs of the university. Materials and Methods: Eight hundred and thirty two elderly subjects in the age range 40-60 years were interviewed using a questionnaire to determine the existence of elder abuse. The subjects were investigated and examined for weight, nutrition and hydration, vital signs, habits, existing visual and auditory capabilities, medications, disclosure of wills/deeds, signs of depression, and documented cleanliness. The mini-mental state examination, the Geriatric Depression Scale, the Clock drawing test, and the Brief Psychiatric Rating Scale were used to determine the potential forensic markers. Statistical Analysis Used: Mean values in percentage were determined by dividing the number of determined subjects by the total number of subjects for that parameter. Results: About 37% in medical and 41% in dental OPDs were found to have suffered from abuse, mostly in the age group 60-70 years. Females received more abuse and a combination of son and daughter-in-law constituted most abusers. Various potential markers of elder abuse and neglect investigated among the elder abuse victims included depression (89%), signs of improper feeding (83%), changes in personal hygiene (69%), need for medical/dental treatment (78%), medication misuse (67%), changes in wills/deeds (26%), decubiti (10%), bruises (17%), skin tears (27%), and confusion (23%). Conclusions: Elder abuse exists in one or more forms in both medical and dental OPDs among both males and females in all age groups.


How to Cite
Khurshid Mattoo, Rishabh Garg, & Shalabh Kumar. (2015). Geriatric forensics - Part 2 "Prevalence of elder abuse and their potential forensic markers among medical and dental patients". Journal of Forensic Dental Sciences, 7(3), 201–206.


  1. Drunkard son kills father. The Times of India. Oct 2011. Available from: drunkard‑son‑killsfather/articleshow/10522821.cms.[Last accessed on 2011 Oct 11].
  2. Drunkard son kills father in Uttar Pradesh. Available from: http://‑ son‑kills‑father‑in‑uttar‑ pradesh/265208‑44.html. [Last accessed on 2012 Jun 09].
  3. Horrifying case of son killed his father rocked the Rae bareli. Available from:‑editions/lucknow/ horrifying‑case‑of‑son‑killed‑his‑father‑rocked‑the‑rae‑bareli. html. [Last accessed on 2013 May 07].
  4. Sons hire contract killer for murdering 70‑year‑old father. Available from:‑pradesh/ sons‑hire‑contract‑killer‑for‑murdering‑70‑year‑old‑father‑379359. html. [Last accessed on 2014 Mar 03].
  5. Man kills father, step‑brother, wife over property dispute. The Times of India. Available from: view/2013/12/30/Man_kills_father_stepbrother_wife_over_ property_dispute/. [Last accessed on 2014 Mar 07].
  6. Inebriated son kills father over trivial issue. Available from: Inebriated‑son‑kills‑father‑over‑trivial‑issue‑arrested/ articleshow/14856652.cms. [Last accessed on 2012 Jul 13].
  7. Elder Justice Roundtable Report: Medical Forensic Issues Concerning Abuse and Neglect. The Department of Justice medical forensic roundtable discussion; Washington, DC. Available from: [Last accessed on 2000 Oct 18].
  8. Shankardass MK. Combating elder abuse in India: An emerging social, legal and public health concern, symposists’ papers, invited symposia on elder abuse, executive editor, Toshio Tatara, Tokyo International Forum, Japan. Indian J Gerontol 2008;22:422‑46.
  9. Dyer CB, Goodwin JS, Pickens‑Pace S, Burnett J, Kelly PA. Self‑neglect among the elderly: A model based on more than 500 patients seen by a geriatric medicine team. Am J Public Health 2007;97:1671‑6.
  10. Lachs MS, Williams CS, O’Brien S, Pillemer KA, Charlson ME. The mortality of elder mistreatment. JAMA 1998;280:428‑32.
  11. Rawson RD, Ommen RK, Kinard G, Johnson J, YfantisA. Statistical evidence for the individuality of the human dentition. J Forensic Sci 1984;29:245‑53.
  12. Mattoo KA, Shalabh K, Khan A. Geriatric forensics: A dentist’s perspective and contribution to identify existence of elder abuse among his patients. J Forensic Dent Sci 2010;2:81‑5.
  13. Folstein MF, Folstein SE, McHugh PR. Mini‑mental state. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189‑98.
  14. Sheikh JI, Yesavage JA. Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. Clin Gerontol 1986;5:165‑73.
  15. Yesavage JA, Brink TL, Rose TL. Development and validation of a geriatric depression screening scale: A preliminary report. J Psychiatr Res 1982;17:37‑49.
  16. Agrell B, Dehlin O. The clock‑drawing test. Age Ageing 1998;27:399‑403.
  17. Bartolomeo P. Visual neglect. Curr Opin Neurol 2007;20:381‑6.
  18. Overall JE, Gorham DR. The brief psychiatric rating scale. Psychol Rep 1962;10:799‑812.
  19. Active ageing: A policy framework. Geneva, World Health Organization, 2002 (WHO/NMH/NPH/02.8). Available from NPH_02.8.pdf. [Last accessed on 2012 July 13].
  20. Hudson M. Analyses of the concepts of elder mistreatment: Abuse and neglect. J Elder Abuse Negl 1988;1:5‑26.
  21. Second World Assembly on Ageing. Plan of Action and Political Declaration. Madrid, Spain 2002.
  22. Soneja S. Elder abuse in India. Country report for World Health Organization. HelpAge‑India. Available from: http://www.who. int/ageing/projects/elder_abuse/alc_ea_ind.pdf. [Last accessed on 2015 Feb 6].
  23. Chokkanathan S, Lee AE. Elder mistreatment in urban India: A community based study. J Elder Abuse Negl 2005;17:45‑61.
  24. Mattoo KA, Shalabh K, Khan A. Prevalence of elder abuse among completely edentulous patients seeking complete denture prosthesis: A survey. J Indian Acad Geriatr 2009;5:177‑80.
  25. Help Age India. Help Age India’s ‘Report on Elder Abuse in India’ brings out some startling facts. Available from: http://www.[Last accessed on 2013 July 10].
  26. The Hindu. Chennai ranks lowest in elder abuse [internet].