The National Institute on Aging of the National Institutes of Health has awarded a grant to Weill Cornell Medicine to develop a screening tool and intervention for elder neglect in patients with Alzheimer’s disease and related dementias.

Approximately one in 10 Americans over the age of 60 have experienced some form of elder abuse, a broad category that encompasses financial exploitation, physical abuse, emotional abuse, neglect and more. For this study, Dr. Mark Lachs, co-chief of the Division of Geriatrics and Palliative Medicine at Weill Cornell Medicine and NewYork-Presbyterian/Weill Cornell Medical Center and the Irene F. and I. Roy Psaty Distinguished Professor of Clinical Medicine at Weill Cornell Medicine, and Dr. Tony Rosen, an associate professor of emergency medicine at Weill Cornell Medicine and emergency medicine physician at NewYork-Presbyterian/Weill Cornell, will focus on elder neglect – or the failure to meet an older adult's basic needs, which include access to food, water, shelter, clothing, hygiene and essential medical care.

“We’re focused specifically on elder neglect because we didn’t want to undermine our ability to understand the phenomenon and identify interventions that work. Each form of elder abuse likely requires a different form of intervention,” Rosen said. “Elder neglect is not only the most common, but it is likely the most severe, in older adults with dementia. And in some ways, it’s the form of elder abuse for which health care providers are likely to have the largest role in prevention, identification and intervention.”

The two-part grant will enable Weill Cornell Medicine researchers across departments and divisions to develop and test a new primary care screening tool to identify elder neglect in patients with Alzheimer’s disease and related dementia and a technology-driven intervention for caregivers.

“Instead of asking a patient a series of questions, we would like to use a clinical checklist in the screening tool. So, we’ll utilize information that you might find in electronic health records or a physical examination,” Rosen said. “It is unclear how many cases of elder neglect we will identify or how impactful intervention will be, but it is important to consider identifying people who might need help.”

In the grant’s second phase, the researchers will conduct a randomized clinical trial to determine the impact of the screening and intervention. They also plan to design a scale of severity, as different degrees of severity may impact intervention. The first phase of the project includes $1.3 million over two years, with second-phase funding over the following three years estimated to bring the overall award to $6 million.

Karl Pillemer, professor of gerontology in medicine at Weill Cornell Medicine and the Hazel E. Reed Professor in the Department of Psychology on Cornell’s Ithaca campus, will serve as a co-investigator on the grant. Lachs and Rosen also plan to partner with Sara Czaja, the Gladys and Roland Harriman Professor of Medicine and director of the Center on Aging and Behavioral Research at Weill Cornell Medicine, in the development of the technology-driven intervention. 

“This is exciting work, and we are thrilled that the National Institute on Aging is dedicating funding to this very serious issue of elder neglect in patients with Alzheimer’s disease and related dementias,” Lachs said.

Molly Schulson is a freelance writer for Weill Cornell Medicine.