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Objectives: To evaluate the association between state-defined elder abuse investigation systems and rates of reported, investigated and substantiated domestic elder abuse.Methods: A mailed survey was administered to 1,763 adult protective service (APS) office investigators in 44 states and the District of Columbia. Information about investigative structures and investigations was obtained from 1,409 of the APS investigators, an 80% return rate. County/district domestic elder abuse report, investigation, and substantiation numbers for each state for 1999 was obtained for APS state administrators.Results: Elder abuse reports to APS offices ranged from 0 to 191.7 per 1,000 elder population. Investigation and substantiation rates ranged from 0 to a high of 150.0 and 116.7, respectively. Investigation rates were higher in counties having investigators only evaluating elder abuse cases, having a social work educational background and feeling that the elders were usually better off after investigation. Longer length of training programs for investigators was associated with high substantiation rates.Discussion: Differences in investigative structures do impact the rates of identified elder abuse. Elder abuse should be examined at the county level to distinguish both state and county/district differences in reported, investigated, and substantiated elder abuse.
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