Since emergency department (ED) visits provide an important opportunity for elder abuse identification, the current study assessed the accuracy of the ED Senior Abuse Identification (ED Senior AID) tool for the identification of elder abuse.
A study was conducted of the ED Senior AID tool in three U.S. EDs. Participants were English-speaking patients 65 years old and older who provided consent or for whom a legally authorized representative provided consent. Research nurses administered the screening tool, which includes a brief mental status assessment, questions about elder abuse, and a physical examination for patients who lack the ability to report abuse or for whom the presence or absence of abuse was uncertain. The reference standard was based on the majority opinion of a longitudinal, expert, all data (LEAD) panel following review and discussion of medical records, clinical social worker notes, and a structured social and behavioral evaluation. For the reference standard, LEAD panel members were blinded to the results of the screening tool. Of 916 enrolled patients, 33 (3.6 percent) screened positive for elder abuse. The LEAD panel reviewed 125 cases: all 33 with positive screen results and a 10 percent random sample of negative screen results. Of these, the panel identified 17 cases as positive for elder abuse, including 16 of the 33 cases that screened positive. The ED Senior AID tool had a sensitivity of 94.1 percent (95 percent confidence interval [CI] 71.3 percent to 99.9 percent) and specificity of 84.3 percent (95 percent CI 76.0 percent to 90.6 percent). This multicenter study found the ED Senior AID tool to have a high sensitivity and specificity as a screening tool for elder abuse, albeit with wide CIs. (publisher abstract modified)