Elder abuse awareness: An elderly person with cracks on their face symbolizing abuse, a hand provides support, Rio de Janeiro in the background.

Unmasking Elder Abuse: Shocking Prevalence and Hidden Risk Factors in Brazil

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Rhea Morgan in Health & Wellness October 2026 • 4 min read.

"New research reveals alarming rates of elder mistreatment in São Paulo and Rio de Janeiro, highlighting urgent needs for prevention and support."


Elder abuse is a global crisis, impacting communities worldwide. Defined as intentional actions causing harm or neglect by trusted individuals, it affects older adults' health and well-being. Recognizing the scope and hidden risk factors is crucial for effective intervention and prevention.

While research highlights significant rates of elder abuse in developed countries, less is known about the situation in developing nations. In Brazil, studies on elder mistreatment are scarce, hindering efforts to protect older adults. Understanding the unique challenges in Brazil is essential to addressing this pressing issue.

A recent study in São Paulo and Rio de Janeiro sheds light on the prevalence and risk factors of elder abuse in Brazil. This groundbreaking research uncovers alarming rates of mistreatment and emphasizes the critical link between mental health and elder abuse, paving the way for targeted prevention strategies and enhanced support systems.

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Risk Factors and Brazilian Evidence

The WHO identifies functional dependence or disability, poor physical health, cognitive impairment, poor mental health, and low income as individual characteristics associated with increased risk of elder abuse. A population-based study analyzed 1,224 community-dwelling adults aged 60 or older in the 2015 wave of the SABE (Health, Well-Being and Aging) study, addressing the limited availability of population-based data from low- and middle-income countries. The supplied material does not report that study’s prevalence findings, so it does not support a specific current prevalence estimate for Brazil.

Reviewing the Evidence Base

An integrative review set out to systematize and evaluate theoretical and empirical studies on elder abuse in Brazil, focusing on the profile of research from the preceding five years. The supplied source description identifies the review approach but does not specify its findings or assess particular measurement tools. A separate 2023 qualitative study describes prevention from a socio-ecological standpoint, pointing to community- and societal-level measures such as education and awareness and a minimum standard.

The Alarming Prevalence of Elder Abuse in Major Brazilian Cities

Elder abuse awareness: An elderly person with cracks on their face symbolizing abuse, a hand provides support, Rio de Janeiro in the background.

The study, conducted in São Paulo and Rio de Janeiro, revealed that elder abuse is a significant issue. The research found that 14.4% of older adults in São Paulo and 13.3% in Rio de Janeiro experienced some form of mistreatment. These figures underscore the urgent need for increased awareness and targeted interventions to protect elderly populations in urban Brazil.

This study employed face-to-face assessments, using a nine-item, Brazil-adapted version of the Hwalek-Sengstock Elder Abuse Screening Test to gather data on elder abuse. Participants, aged 60–75, were selected from representative samples in both cities. Sampling design-adjusted descriptive statistics and logistic regression analyses were used to analyze the data, providing prevalence estimates and identifying potential correlates.

  • Study Design: Cross-sectional data collection through face-to-face assessments.
  • Setting: São Paulo and Rio de Janeiro, Brazil.
  • Participants: Individuals aged 60 to 75.
  • Measurement Tool: Brazil-adapted, nine-item Hwalek-Sengstock Elder Abuse Screening Test.
  • Analysis: Sampling design-adjusted descriptive statistics and logistic regression.
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Reported Prevalence Estimates

One source reports that elder abuse rates in Brazil range from 10% to 21%, and cites an estimated prevalence of 14.4% in São Paulo attributed to Blay et al. (2017). A 2020 analysis of reports of neglect and psychological abuse among older adults in a Brazilian state, covering 2011–2018, reports adjusted prevalence of psychological abuse as 4; the supplied snippet does not provide a unit or further detail. These figures refer to different study contexts, so they should not be treated as directly comparable estimates.

Associations and Measurement Limits

In the São Paulo and Rio de Janeiro study, poor education, low physical activity, unemployment, heart disease, and psychiatric problems were associated with abuse in unadjusted analyses; after adjustment, only psychiatric problems remained significantly associated with self-reported abuse. The reported adjusted odds ratios were 4.48 in São Paulo (95% CI 1.75–11.45) and 21.61 in Rio de Janeiro (95% CI 6.39–73.14). Measurement limitations also matter: a Colombian study noted that self-reported data and a scale that did not measure intentionality or severity limited accurate comparisons, while a systematic review rated the psychometric properties of abuse instruments as insufficient and the evidence as low quality. In Paraíba, the Hwalek-Sengstock Elder Abuse Screening Test had α = 0.08, compared with α = 0.57 in Pernambuco.

A Global Benchmark

A systematic review and meta-analysis estimated the pooled prevalence of overall elder abuse in community settings at 15.7% (95% CI 12.8–19.3). A report on multiple abuse against older adults in three Brazilian cities cites the same 15.7% figure from a systematic review of 52 studies published between 2002 and 2015 across 28 countries. The shared figure provides a broad international benchmark, but the supplied material does not establish that it is a Brazil-specific estimate or directly comparable to individual Brazilian city studies.

While various factors were analyzed, the study revealed that psychiatric problems were the most significant correlate of elder abuse in both cities. In São Paulo, the odds ratio (OR) was 4.48, with a 95% confidence interval (CI) of 1.75–11.45; in Rio de Janeiro, the OR was a striking 21.61, with a 95% CI of 6.39–73.14. These results indicate a strong association between mental health issues and the likelihood of elder abuse.

Taking Action: Prioritizing Mental Health and Protecting Our Elders

This study underscores the urgent need to address elder abuse in Brazil, highlighting the critical role of mental health. Raising awareness, implementing preventive measures, and providing comprehensive support for both victims and caregivers are essential steps. By prioritizing mental health and promoting respectful, supportive environments, we can protect our elders and ensure their well-being.

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From Population Research to Better Responses

A population-based São Paulo study analyzed data from 1,224 community-dwelling adults aged 60 or older, highlighting research aimed at addressing limited population-based evidence from low- and middle-income countries. The supplied description does not include the study’s specific association findings, so no particular risk factor can be attributed to it here. Separately, research on notifications of elder abuse in Brazil says it can contribute to better strategies, more appropriate actions, and healthcare services for victims.

Where the study's conclusions are bounded

  • The outcome was self-reported, so the reported association concerns participants’ accounts of abuse.[1]

A face-to-face survey of adults in São Paulo and Rio de Janeiro

Study designObservational study[1]
PopulationIndividuals aged 60 to 75[1]
Sample sizeSão Paulo: 259; Rio de Janeiro: 197[1]
SettingSão Paulo and Rio de Janeiro, Brazil[1]
Main outcomePrevalence of elder abuse[1]
Effect sizePrevalence: 14.4% in São Paulo and 13.3% in Rio de Janeiro; adjusted association with psychiatric problems: OR = 4.48 in São Paulo and OR = 21.61 in Rio de Janeiro[1]
Confidence intervalSão Paulo prevalence: 9.82-20.61; Rio de Janeiro prevalence: 8.76-19.74; psychiatric problems OR in São Paulo: 1.75-11.45; in Rio de Janeiro: 6.39-73.14[1]
Times cited26[1]

How later and broader estimates relate

A review spanning studies from multiple countries reported a community estimate of 15.7%. It offers international context, not a Brazil-specific benchmark for either city.[2]

The 2020 state-report analysis concerns psychological abuse and neglect records, not the same overall outcome measured in the city survey; its excerpt gives no complete prevalence figure for comparison.[3]

What the evidence leaves unresolved

  • Would tracking participants over time clarify whether psychiatric problems tend to precede abuse, follow it, or occur alongside it?[1]

Sources

  1. Prevalence and Correlates of Elder Abuse in São Paulo and Rio de Janeiro (Wiley, 2017)
  2. Report of multiple abuse against older adults in three Brazilian cities (pmc.ncbi.nlm.nih.gov)
  3. Neglect and psychological abuse of older adults in a Brazilian state: analysis of reports between 2011 and 2018 (2020)

About this Article -

Written with AI assistance from published research, and reviewed by the Mystum team. See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1111/jgs.15106, Alternate LINK

Title: Prevalence And Correlates Of Elder Abuse In São Paulo And Rio De Janeiro

Subject: Geriatrics and Gerontology

Journal: Journal of the American Geriatrics Society

Publisher: Wiley

Authors: Sergio L. Blay, Jerson Laks, Valeska Marinho, Ivan Figueira, Deborah Maia, Evandro S. F. Coutinho, Ines M. Quintana, Marcelo F. Mello, Rodrigo A. Bressan, Jair J. Mari, Sergio B. Andreoli

Published: 2017-09-12

Everything You Need To Know

1

What exactly is elder abuse, and why is it important to recognize and address it?

Elder abuse encompasses intentional actions or neglect by individuals who are trusted, resulting in harm or distress to older adults. This mistreatment can take various forms, impacting the physical, emotional, and financial well-being of the elderly. Recognizing elder abuse is crucial because it is a global crisis that affects communities worldwide. By understanding its scope and hidden risk factors, effective intervention and prevention strategies can be developed to protect our aging population.

2

What is the Hwalek-Sengstock Elder Abuse Screening Test, and why is it a significant tool in identifying elder abuse?

The Hwalek-Sengstock Elder Abuse Screening Test is a tool used to identify potential cases of elder abuse. It is significant because it provides a structured method for assessing the presence of mistreatment among older adults. The Brazil-adapted, nine-item version of this test was used in a recent study to gather data on elder abuse through face-to-face assessments. This allows researchers and practitioners to systematically evaluate and address the issue, leading to more informed interventions and support.

3

What are sampling design-adjusted descriptive statistics and logistic regression, and why are they important in analyzing elder abuse data?

Sampling design-adjusted descriptive statistics and logistic regression are statistical methods used to analyze data related to elder abuse. These methods are important because they allow researchers to estimate the prevalence of elder abuse and identify potential factors that correlate with it. By using these analytical techniques, the study in São Paulo and Rio de Janeiro was able to provide prevalence estimates and reveal that psychiatric problems were the most significant correlate of elder abuse in both cities. This information is crucial for developing targeted prevention strategies and support systems.

4

What is an odds ratio (OR), and how was it used to determine the relationship between psychiatric problems and elder abuse?

The odds ratio (OR) is a measure of association between an exposure (such as a risk factor) and an outcome (such as elder abuse). A higher odds ratio indicates a stronger association. In the context of the study, the OR was used to quantify the relationship between psychiatric problems and elder abuse. For example, in Rio de Janeiro, the OR was 21.61, indicating that older adults with psychiatric problems were more than twenty times more likely to experience elder abuse than those without such problems. This highlights the critical role of mental health in addressing elder abuse.

5

What is the significance of the study focusing on individuals aged 60 to 75 in São Paulo and Rio de Janeiro when studying elder abuse?

The study focused on individuals aged 60 to 75 in São Paulo and Rio de Janeiro. This age range is significant because it represents a segment of the population that is particularly vulnerable to elder abuse while still being relatively active and integrated within their communities. Focusing on this demographic allows researchers to understand the specific challenges and risk factors affecting this age group in urban Brazil. Understanding this age range is an important part of prioritizing mental health and protecting our elders.

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