Reading between the lines - Older people’s maltreatment, from detection to reporting in primary healthcare

Sep 30, 2026

Older people’s maltreatment (OPM) has growing international attention due to severe short- and long-term consequences. Healthcare professionals are key for detecting, reporting, and managing suspected cases, yet difficulties and frequent underreporting persist. This cross-sectional survey assessed Portugal general practice physicians’ perceptions, experiences, and challenges in detecting and reporting OPM. The 13-item anonymous questionnaire analyzed sociodemographic factors, responsibility, confidence, reporting practices, and training needs among 356 respondents.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Abstract

Introduction

Background on older people maltreatment (OPM)

Evidence on reporting practices and prevalence

International concern and conceptual challenges

Frazão etal. BMC Public Health (2026) 26:60 BMC Public Health [https://doi.org/10.1186/s12889-025-25394-1](https://doi.org/10.1186/s12889-025-25394-1) RESEARCH Open Access Reading between the lines. Older people’s maltreatment-from detection to reporting in primary healthcare S. Frazão 1,2*†, C. Morais3†, P. Norton 1,4,5,6, P. Vieira Pinto 7,8,10 and T. Magalhães9,11 Abstract The issue of older people’s maltreatment (OPM) is gaining increased attention worldwide because of its significant short and long-term severe consequences. Healthcare professionals play a crucial role in detecting, reporting, and managing these cases, but many difficulties in these procedures exist, and underreporting is very frequent. Thus, the aim of this study was to identify the extent of and difficulties in detecting and reporting suspected OPM cases by general practitioner physicians in Portugal. A cross-sectional survey was conducted among general practice physicians (GPPs) to assess their perceptions, experiences, and challenges in detecting and reporting older people maltreatment (OPM) . The 13-item questionnaire explored sociodemographic factors, responsibility, confidence, reporting practices, and training needs, providing an updated insight into OPM management in primary healthcare. It was anonymous and conducted through a self-report questionnaire distributed in paper format to GPPs working in the National Health Service in the Northern of Portugal. We received 356 completed questionnaires for further analysis. The findings indicate that, on average, physicians suspect fewer than one OPM case per year; only 32% suspected at least one case in the previous year, although 55. 3% and 54. 5% of the physician’s revealed confidence in identifying signs of physical abuse and neglect, respectively. The ambiguity of the psychological symptoms was identified as a great challenge in detection (50 . 3%) . Only 36. 5% of the physicians were acquainted with the procedures for reporting suspected cases; however, of the 32% who suspected at least of one case in the previous year, only 39. 5% reported all or at least some suspected cases; 16. 9% chose not to report the case when requested by the victim or his/her caregivers. Most (91 . 6%) expressed a willingness to adopt protocols to assist them in managing such cases. A correlation was found between physicians’ satisfaction with OPM reporting training during undergraduate and postgraduate education and their ability to report (p = 0 . 024), as well as with the number of reported cases (p = 0 . 003) . Thus, the detection and reporting of OPM by physicians remain major challenges that need to be overcome. Further research and greater awareness of the importance of these procedures are essential to ensure victims’ protection, safety, and health. Keywords Older people, Maltreatment, Abuse, Neglect, Physician, Primary care †S. Frazão and C. Morais contributed equally to this work. *Correspondence: S. Frazão[lalanda77@hotmail.com](lalanda77@hotmail.com) Full list of author information is available at the end of the article © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use,

FAQs

What is the main purpose of the study described in the abstract?

To identify the extent of, and difficulties in, detecting and reporting suspected older people’s maltreatment cases by general practitioner physicians in Portugal.

How was data collected from general practice physicians?

A cross-sectional survey used a 13-item anonymous self-report questionnaire distributed in paper format to general practice physicians working in Portugal’s National Health Service.

What challenges do physicians face according to the reported findings?

Physicians suspected fewer than one case per year on average, many had limited familiarity with reporting procedures, and ambiguity in psychological symptoms was highlighted as a major detection challenge.

Sep 30, 2026

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