Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Investigating the connection between ageism and elder mistreatment


Elder mistreatment is recognized as a pervasive public health problem with detrimental consequences for older adults and society. Although considerable research has examined elder mistreatment risk factors at the individual level, there is a growing call for the field to move beyond proximal causes and consider underlying structural factors that influence elder mistreatment. Illustrating this shift, organizations, advocacy groups and researchers have proposed a connection between ageism and elder mistreatment. However, despite the assertion that ageism is a causal factor for elder mistreatment, there is a scarcity of research to demonstrate this relationship. In this Perspective, we examine the proposed conceptual pathways and limited empirical research connecting ageism and elder mistreatment. After identifying critical gaps in current knowledge, we propose a model that links ageism and elder mistreatment and a research agenda to bring conceptual clarity and empirical evidence to the study of this topic.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Rent or buy this article

Get just this article for as long as you need it


Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Elder mistreatment subtypes.
Fig. 2: Conceptual model illustrating pathways through which ageism leads to elder mistreatment.


  1. Pillemer, K., Burnes, D., Riffin, C. & Lachs, M. S. Elder abuse: global situation, risk factors, and prevention strategies. Gerontologist 56, S194–S205 (2016).

    Article  Google Scholar 

  2. Lachs, M. S. & Pillemer, K. Elder abuse. N. Engl. J. Med. 373, 1947–1956 (2015).

    Article  CAS  Google Scholar 

  3. Breckman, R. et al. When helping hurts: nonabusing family, friends, and neighbors in the lives of elder mistreatment victims. Gerontologist 58, 719–723 (2018).

    Article  Google Scholar 

  4. World Health Organization. World Report on Ageing and Health (World Health Organization, 2015).

  5. National Research Council. Elder Mistreatment: Abuse, Neglect, and Exploitation in an Aging America (National Academies Press, 2003).

  6. Yon, Y., Mikton, C. R., Gassoumis, Z. D. & Wilber, K. H. Elder abuse prevalence in community settings: a systematic review and meta-analysis. Lancet Glob. Health 5, e147–e156 (2017).

    Article  Google Scholar 

  7. Acierno, R., Hernandez-Tejada, M. A., Anetzberger, G. J., Loew, D. & Muzzy, W. The National Elder Mistreatment Study: an 8-year longitudinal study of outcomes. J. Elder Abuse Negl. 29, 254–269 (2017).

    Article  Google Scholar 

  8. Yunus, R. M., Hairi, N. N. & Choo, W. Y. Consequences of elder abuse and neglect: a systematic review of observational studies. Trauma Violence Abuse 20, 197–213 (2019).

    Article  Google Scholar 

  9. Easton, S. D. & Kong, J. Childhood adversities, midlife health, and elder abuse victimization: a longitudinal analysis based on cumulative disadvantage theory. J. Gerontol. B Psychol. Sci. Soc. Sci. (2020).

  10. Stevens, M., Biggs, S., Dixon, J., Tinker, A. & Manthorpe, J. Interactional perspectives on the mistreatment of older and vulnerable people in long-term care settings. Br. J. Sociol. 64, 267–286 (2013).

    Article  Google Scholar 

  11. World Health Organization. Elder Abuse (World Health Organization, 2020).

  12. Officer, A. & de la Fuente-Núñez, V. A global campaign to combat ageism. Bull. World Health Organ. 96, 295–296 (2018).

    Article  Google Scholar 

  13. Marques, S. et al. Determinants of ageism against older adults: a systematic review. Int. J. Environ. Res. Public Health 17, 2560–2582 (2020).

    Article  Google Scholar 

  14. Bugental, D. B. & Hehman, J. A. Ageism: a review of research and policy implications. Soc. Issues Policy Rev. 1, 173–216 (2007).

    Article  Google Scholar 

  15. Walsh, C. A., Olson, J. L., Ploeg, J., Lohfeld, L. & MacMillan, H. L. Elder abuse and oppression: voices of marginalized elders. J. Elder Abuse Negl. 23, 17–42 (2012).

    Article  Google Scholar 

  16. Imbody, B. & Vandsburger, E. Elder abuse and neglect: assessment tools, interventions, and recommendations for effective services provision. Educ. Gerontol. 37, 634–650 (2011).

    Article  Google Scholar 

  17. Harbison, J. Models of intervention for ‘elder abuse and neglect’: a Canadian perspective on ageism, participation, and empowerment. J. Elder Abuse Negl. 10, 1–17 (1999).

    Article  Google Scholar 

  18. Phelan, A. & Ayalon, L. The intersection of ageism and elder abuse. in Advances in Elder Abuse Research Vol. 24 (Ed. Phelan, A.) 11–22 (Springer, 2020).

  19. Phelan, A. Elder abuse, ageism, human rights, and citizenship: implications for nursing discourse. Nurs. Inq. 15, 320–329 (2008).

    Article  Google Scholar 

  20. Dow, B. & Joosten, M. Understanding elder abuse: a social rights perspective. Int. Psychogeriatr. 24, 853–855 (2012).

    Article  Google Scholar 

  21. Shepherd, B. F. & Brochu, P. M. How do stereotypes harm older adults? A theoretical explanation for the perpetration of elder abuse and its rise. Aggress. Violent Behav. (2020).

  22. Yon, Y. et al. Is ageism in university students associated with elder abuse? J. Intergen. Relationships 8, 386–402 (2010).

    Article  Google Scholar 

  23. Yechezkel, R. & Ayalon, L. Social workers’ attitudes towards intimate partner abuse in younger vs. older women. J. Fam. Violence 28, 381–391 (2013).

    Article  Google Scholar 

  24. Erlingsson, C. L., Carlson, S. L. & Saveman, B. I. Perceptions of elder abuse: voices of professionals and volunteers in Sweden—an exploratory study. Scand. J. Caring Sci. 20, 151–159 (2006).

    Article  Google Scholar 

  25. Bužgová, R. & Ivanová, K. Elder abuse and mistreatment in residential settings. Nurs. Ethics 16, 110–126 (2009).

    Article  Google Scholar 

  26. Drennan, J. et al. Older People in Residential Care Settings: Results of a National Survey of Staff–Resident Interactions and Conflicts (National Centre for the Protection of Older People, University College Dublin, 2012).

  27. Pillemer, K. & Moore, D. W. Abuse of patients in nursing homes: findings from a survey of staff. Gerontologist 29, 314–320 (1989).

    Article  CAS  Google Scholar 

  28. Capaldi, D. M., Knoble, N. B., Shortt, J. W. & Kim, H. K. A systematic review of risk factors for intimate partner violence. Partner Abuse 3, 231–280 (2012).

    Article  Google Scholar 

  29. Stith, A. M., Smith, D. B., Penn, C. E., Ward, D. B. & Tritt, D. Intimate partner physical abuse perpetration and victimization risk factors: a meta-analytic review. Aggress. Violent Behav. 10, 65–98 (2004).

    Article  Google Scholar 

  30. Ateah, C. A. & Durrant, J. E. Maternal use of physical punishment in response to child misbehavior: implications of child abuse prevention. Child Abuse Negl. 29, 169–185 (2005).

    Article  Google Scholar 

  31. Rodriguez, C. M., Bower-Russa, M. B. & Harmon, N. Assessing abuse risk beyond self-report: analog task of acceptability of parent–child aggression. Child Abuse Negl. 35, 199–209 (2011).

    Article  Google Scholar 

  32. Vittrup, B., Holden, G. W. & Buck, J. Attitudes predict the use of physical punishment: a prospective study of the emergence of disciplinary practices. Pediatrics 117, 2055–2064 (2006).

    Article  Google Scholar 

  33. Gracia, E., Rodriguez, C. M., Martín-Fernández, M. & Lila, M. Acceptability of family violence: underlying ties between intimate partner violence and child abuse. J. Interpers. Violence 35, 3217–3236 (2017).

    Article  Google Scholar 

  34. Durrant, J., Rose-Krasnor, L. & Brobeg, A. G. Physical punishment and maternal beliefs in Sweden and Canada. J. Comp. Fam. Stud. 34, 3217–3236 (2003).

    Google Scholar 

  35. Lansford, J. E., Deater-Deckard, K., Bornstein, M., Putnick, D. L. & Bradley, R. H. Attitudes justifying domestic violence predict endorsement of corporal punishment and physical and psychological aggression towards children: a study in 24 low- and middle-income countries. J. Pediatr. 164, 1208–1213 (2014).

    Article  Google Scholar 

  36. Salari, S. M. & Rich, M. Social and environmental infantilization of aged persons: observations in two adult day care centers. Int. J. Aging Hum. Dev. 52, 115–134 (2001).

    Article  CAS  Google Scholar 

  37. Jongsma, K. & Schweda, M. Return to childhood? Against the infantilization of people with dementia. Bioethics 32, 414–420 (2018).

    Article  Google Scholar 

  38. Burnes, D., Lachs, M. S. & Pillemer, K. Addressing the measurement challenge in elder abuse interventions: need for a severity framework. J. Elder Abuse Negl. 30, 402–407 (2018).

    Article  Google Scholar 

  39. Seddig, D., Maskileyson, D. & Davidov, E. The comparability of measures in the ageism module of the fourth round of the European social survey, 2008–2009. Surv. Res. Methods 14, 351–364 (2020).

    Google Scholar 

  40. Kim, J.-H., Song, A., Chung, S., Kwak, K. B. & Lee, Y. The comparative macro-level ageism index: an international comparison. J. Aging Soc. Policy (2020).

  41. Lahey, J. N. International comparison of age discrimination laws. Res. Aging 32, 679–697 (2010).

    Article  Google Scholar 

  42. Officer, A., Thiyagarajan, J. A., Schneiders, M. L., Nash, P. & de la Fuente-Núñez, V. Ageism, healthy life expectancy, and population ageing: how are they related. Int. J. Environ. Res. Public Health 17, 3159 (2020).

    Article  Google Scholar 

  43. Wolf, L. E. et al. Certificates of Confidentiality: protecting human subject research data in law and practice. J. Law Med. Ethics 43, 594–609 (2015).

    Article  Google Scholar 

  44. Storey, J. E. Risk factors for elder abuse and neglect: a review of the literature. Aggress. Violent Behav. 50, 101339 (2020).

    Article  Google Scholar 

  45. Pillemer, K., Connolly, M. T., Breckman, R., Spreng, N. & Lachs, M. S. Elder mistreatment: priorities for consideration by the White House Conference on Aging. Gerontologist 55, 320–327 (2015).

    Article  Google Scholar 

  46. Burnes, D. et al. Interventions to reduce ageism against older adults: a systematic review and meta-analysis. Am. J. Public Health 109, e1–e9 (2019).

    Article  Google Scholar 

Download references


We thank D. Hancock for helpful comments on this article. K.P. acknowledges support from an Edward R. Roybal Center Grant from the National Institute on Aging (P30AG022845). D.B. acknowledges support from the National Institute on Aging (R01AG060080-0).

Author information

Authors and Affiliations



K.P. led manuscript writing and collaborated on manuscript conceptualization, editing and revisions; D.B. collaborated on manuscript conceptualization, writing, editing and revisions; and A.M. collaborated on manuscript conceptualization, writing, editing and revisions.

Corresponding author

Correspondence to Karl Pillemer.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Peer review information Nature Aging thanks Briony Dow, Gill Livingston and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Pillemer, K., Burnes, D. & MacNeil, A. Investigating the connection between ageism and elder mistreatment. Nat Aging 1, 159–164 (2021).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI:

This article is cited by


Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing