Theory and Research-informed Practice

Theoretical Models

Theories are essential to explain the complex causes, risk factors, inter-relational dynamics, and consequences of elder mistreatment.¹ They frame the way research is conducted, collected, and analyzed and inform identification of patterns, themes, and tendencies that influence appropriate strategies for intervention. In addition to improving practice measures to prevent and detect abuse, theory is critical to the development of policies that advance the education of practitioners and knowledge in the field.² Early theoretical models have been critiqued for several reasons, including their limited scope, discipline-specific focus, and failure to consider cultural implications.³ While there is no current theoretical consensus, a number of approaches have emerged that lend insight to the area, including the ecological model,⁴ the abuse intervention/prevention model,⁵ contextual framework,⁶ trauma-based theories,⁷ and stress process theory.⁸

Research and Data

The statistics and data below provide information about the growing older adult population, definitions of abuse, the prevalence of mistreatment, and risk and protective factors for mistreatment, among other key topic areas. The research-based findings are sourced to peer-reviewed publications, articles, and relevant government agency data. Please note that the information referenced is based upon a variety of studies, each reflecting the author’s respective orientation, the type of research conducted, methods employed, measures evaluated, study-specific operational definitions, and contextually related data sets.

The Growing Older Population

As of 2018 there were 52.4 million adults 65 and over in the United States.⁹ By 2040, that number is expected to climb to 80 million,¹⁰ comprising nearly 21% of the total population.¹¹ People aged 85 and older are predicted to almost triple from their current 6.7 million to 19 million by 2060.¹² For the first time, in 2034, it is anticipated that older Americans will outnumber children.¹³ Declining rates of fertility and the aging of the baby boom generation are believed to contribute to the increasing ranks of older adults nationwide.¹⁴

Demographic Snapshot of Older Adults in the United States

Life expectancy has risen from 68 years in the mid-20ᵗʰ century to the current average of about 81 years for women and 76 years for men.¹⁵
In 2018, there were 29.1 million older women in the United States, compared with 23.3 million older men.¹⁶
Overall, approximately 28% of older people live alone.¹⁷ More than 25% of those who live by themselves are older women aged 65–74. For women between the ages of 75–84, the proportionate share jumps to 39%, and for women over 85, 55% live by themselves.¹⁸
In 2022, 5.9 million people 65+ lived below the poverty level. Another 2.7 million had incomes at or just above the poverty level (near-poor).¹⁹
In 2022, 1.3 million adults aged 65 and older lived in nursing homes.²⁰ The CDC estimates that approximately 82% of nursing home residents are 65 and older.²¹
It is expected that by 2030, there will be a 50% increase in the number of elders over the age of 65 who require nursing home care.²²
The number of older Americans living with Alzheimer’s disease will likely more than double from 5.8 million to 13.8 million in 2050.²³
Nearly 10% of U.S. adults ages 65 and older have dementia. Another 22% have mild cognitive impairment.²⁴
With an aging population, there will be an increased need for caregiving. In 2021–2022, 37.1 million family caregivers provided unpaid care to a family or non-family member 65 and older.²⁵ Family caregivers ages 55 to 64 (21%) were the most likely to provide care to someone 65 or older, followed by those ages 45 to 54 (20%) and 65 and older (15%).²⁶

Research, Statistics, and Data Definitions, Types of Elder
Mistreatment, and Prevalence

References

¹ Jackson, S. L., & Hafemeister, T. L. (2016). Theory-based models enhancing the understanding of four types of elder maltreatment. International review of victimology, 22(3), 289-320.
² Roberto, K. A., & Teaster, P. B. (2017). Theorizing elder abuse. Elder abuse, 21-41.
³ Roberto, K. A., & Teaster, P. B. (2017). Theorizing elder abuse. Elder abuse, 21-41. Springer, Cham.
⁴ Phelan, A., & O’Donnell, D. (2020). An Ecological Perspective on Elder Abuse Interventions. Advances in Elder Abuse Research, 193-221.
⁵ Mosqueda, L., Burnight, K., Gironda, M. W., Moore, A. A., Robinson, J., & Olsen, B. (2016). The abuse intervention model: A pragmatic approach to intervention for elder mistreatment. Journal of the American Geriatrics Society, 64(9), 1879-1883.
⁶ Roberto, K. A., & Teaster, P. B. (2017). Theorizing elder abuse. Elder abuse, 21-41..
⁷ DePrince, A. P., & Jackson, S. L. (2020). Moving the field forward: elucidating the nexus between elder abuse and trauma. Journal of Trauma and Dissociation, 151-157.
⁸ Wong, J. S., & Waite, L. J. (2017). Elder mistreatment predicts later physical and psychological health: Results from a national longitudinal study. Journal of elder abuse & neglect, 29(1), 15-42.
⁹ Administration on Aging, (2020, May). 2019 profile of older Americans. Retrieved from https://acl.gov/sites/default/files/Aging%20and%20Disability%20in%20America/2019ProfileOlderAmericans508.pdf
¹⁰ Urban Institute. (2015, April 3). The US population is aging. Retrieved from https://www.urban.org/policy-centers/cross-center-initiatives/program-retirement-policy/projects/data-warehouse/what-future-holds/us-population-aging#:~:text=The%20number%20of%20Americans%20ages,The%20nation%20is%20aging.
¹¹ Nasser, H. (2019). The graying of America: More older adults than kids by 2035. Retrieved from https://www.census.gov/library/stories/2018/03/graying-america.html#:~:text=Starting%20in%202030%2C%20when%20all,add%20a%20half%20million%20centenarians.
¹² PRB. (2019). The U.S. population is growing older, and the gender gap in life expectancy is narrowing. Retrieved from https://www.prb.org/the-u-s-population-is-growing-older-and-the-gender-gap-in-life-expectancy-is-narrowing/
¹³ Vespa, J. (2018). The U.S. joins other countries with large aging population. Retrieved from https://www.census.gov/library/stories/2018/03/graying-america.html#:~:text=Starting%20in%202030%2C%20when%20all,add%20a%20half%20million%20centenarians.
¹⁴ Vespa, J. (2018). The U.S. joins other countries with large aging population. Retrieved from https://www.census.gov/library/stories/2018/03/graying-america.html#:~:text=Starting%20in%202030%2C%20when%20all,add%20a%20half%20million%20centenarians.
¹⁵ PRB. (2019, July). Fact sheet: Aging in the United States. Retrieved from https://www.prb.org/aging-unitedstates-fact-sheet/
¹⁶ Administration on Aging, (2020, May). 2019 profile of older Americans. Retrieved from https://acl.gov/sites/default/files/Aging%20and%20Disability%20in%20America/2019ProfileOlderAmericans508.pdf
¹⁷ Administration on Aging, (2020, May). 2019 profile of older Americans. Retrieved from https://acl.gov/sites/default/files/Aging%20and%20Disability%20in%20America/2019ProfileOlderAmericans508.pdf
¹⁸ PRB. (2019, July). Fact sheet: Aging in the United States. Retrieved from https://www.prb.org/aging-unitedstates-fact-sheet/
¹⁹ Administration for Community Living. (2024). 2023 Profile of older Americans. Retrieved from https://acl.gov/sites/default/files/Profile%20of%20OA/ACL_ProfileOlderAmericans2023_508.pdf
²⁰ Administration for Community Living. (2024). 2023 Profile of older Americans. Retrieved from https://acl.gov/sites/default/files/Profile%20of%20OA/ACL_ProfileOlderAmericans2023_508.pdf
²¹ Centers for Disease Control and Prevention. (2025). Data from the National Post-acute and Long-Term Care Study, National Center for Health Statistics. Retrieved from https://www.cdc.gov/nchs/npals/webtables/overview.htm
²² PRB. (2019, July). Fact sheet: Aging in the United States. Retrieved from https://www.prb.org/aging-unitedstates-fact-sheet/
²³ PRB. (2019, July). Fact sheet: Aging in the United States. Retrieved from https://www.prb.org/aging-unitedstates-fact-sheet/
²⁴ Manly, J. J., Jones, R. N., Langa, K. M., Ryan, L. H., Levine, D. A., McCammon, R., Heeringa, S. G., & Weir, D. (2022). Estimating the Prevalence of Dementia and Mild Cognitive Impairment in the US: The 2016 Health and Retirement Study Harmonized Cognitive Assessment Protocol Project. Archives of Neurology (Chicago), 79(12), 1242–1249. https://doi.org/10.1001/jamaneurol.2022.3543
²⁵ Administration for Community Living. (2024). 2023 Profile of older Americans. Retrieved from https://acl.gov/sites/default/files/Profile%20of%20OA/ACL_ProfileOlderAmericans2023_508.pdf
²⁶ Administration for Community Living. (2024). 2023 Profile of older Americans. Retrieved from https://acl.gov/sites/default/files/Profile%20of%20OA/ACL_ProfileOlderAmericans2023_508.pdf