Sexual Abuse, Trauma and Dementia in the Elderly: A Retrospective Study of 284 Cases

The study objective was to compare elders with a dementia with those without a dementia as to method of disclosure of sexual abuse, forensic markers of sexual abuse and legal outcome of cases. A convenience sample was obtained of 284 forensic cases known to a multidisciplinary group of professionals who investigated, examined or consulted on elder sexual abuse victims. The Comprehensive Sexual Assault Assessment (CSAAT) was used to enter data from case files. 60 percent of the 284 elders were diagnosed with some degree of dementia. Elders with dementia, compared to those without a diagnosis, were abused more often by persons known to them (family member, caregiver or another nursing home resident) than a stranger, presented behavior cues of distress rather than verbal disclosures, were easily confused and verbally manipulated, and were beaten. Suspects who were identified whom abused elders with dementia had less chance of being arrested, indicted or plea bargained. All reported suspected cases of elder sexual abuse need a complete physical examination as well as a sexual assault evidence kit. Patterns of verbal, behavioral or physical changes of elders can be used to support an allegation of sexual assault.