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Chapter 12 - Sexual Assault in Elders

Published online by Cambridge University Press:  11 July 2020

Kim A. Collins
Affiliation:
LifePoint Inc, South Carolina
Roger W. Byard
Affiliation:
University of Adelaide
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Summary

Presentations of sexual assault in women and men aged 60 years and over are infrequent occurrences for both sexual assault medicine services and the forensic pathologist. The presentations of elderly sexual assault victims share characteristics with younger victims, but also involve unique vulnerabilities, important clinical differences, and barriers they must overcome to report.

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Publisher: Cambridge University Press
Print publication year: 2020

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References

United States Census Bureau. National population projections. 2014. https://census.gov/data/tables/2014/demo/popproj/2014-summary-tables.Google Scholar
World Health Organization. World Report on Ageing and Health. 2015. www.who.int/ageing/publications/world-report-2015/en/ (accessed October 31, 2019).Google Scholar
Brookmeyer, R, Abdalla, N, Kawas, CH, Corrada, MM. Forecasting the prevalence of preclinical and clinical Alzheimer’s disease in the United States. Alzheimers & Dementia 2018; 14(2): 121–9.CrossRefGoogle ScholarPubMed
World Health Organization. Elder abuse. Geneva, 2014. Fact Sheet No. 357. www.who.int/mediacentre/factsheets/fs357/en/Google Scholar
Cooper, C, Selwood, A, Livingston, G. The prevalence of elder abuse and neglect: a systematic review. Age and Ageing 2008; 37(2): 151–60.CrossRefGoogle ScholarPubMed
US National Research Panel to Review Risk and Prevalence of Elder Abuse and Neglect (2003), quoted in Donovan, K, Regehr, C. Elder abuse: clinical, ethical and legal considerations in social work practice. Clinical Social Work Journal 2010; 38: 174–82.Google Scholar
Gibbs, L, Mosqueda, J. The importance of reporting mistreatment of the elderly. American Family Physician 2007; 75(5): 628.Google ScholarPubMed
Teaster, P, Dugar, DA, Tyler, A, et al. The 2004 Survey of State Adult Protective Services: Abuse of Adults Aged 60 Years of Age and Older. Washington, DC: US Administration on Aging; 2006.Google Scholar
Ramsey-Klawsnik, H. Elder sexual abuse: preliminary findings. Journal of Elder Abuse and Neglect 1991; 3(3): 7390.CrossRefGoogle Scholar
Mann, R, Horsley, P, Barrett, C, Tinney, J. Norma’s Project. A Research Study into the Sexual Assault of Older Women in Australia, ARCSHS Monograph Series No. 98. La Trobe University, Melbourne, Australia: Australian Research Centre in Sex, Health and Society; 2014.Google Scholar
Acierno, R, Hernandez, MA, Amstadter, AB, et al. Prevalence and correlates of emotional, physical, sexual, and financial abuse and potential neglect in the united states: The National Elder Mistreatment Study. American Journal of Public Health 2010; 100(2): 292–7.Google Scholar
Burgess, AW, Hanrahan, NP, Baker, T. Forensic markers in elder female sexual abuse cases. Clinics in Geriatric Medicine 2005; 21: 399412.Google Scholar
Speck, P, Hartig, MT, Likes, W, et al. Case series of sexual assault in older persons. Clinics in Geriatric Medicine 2014; 30: 779806.Google Scholar
Burgess, AW, Phillips, SL. Sexual abuse, trauma and dementia in the elderly: a retrospective study of 284 cases. Victims & Offenders 2006; 1(2): 193204.Google Scholar
Pinto, A, Rodrigues, F, Dinis-Oliveira, RJ, Magalhães, T. Sexual offences against elderly people: forensic evaluation and judicial outcome. Journal of Elder Abuse and Neglect 2014; 26: 189204.CrossRefGoogle Scholar
Terranova, C, Bevilacqua, G, Zen, M, Montisci, M. Crimes against the elderly in Italy. Journal of Forensic and Legal Medicine 2017; 50: 20–7.Google Scholar
Ball, HN, Fowler, D. Sexual offending against older female victims: an empirical study of the prevalence and characteristics of recorded offences in a semi-rural English county. The Journal of Forensic Psychiatry & Psychology 2008; 19: 1432.CrossRefGoogle Scholar
Ramin, S, Satin, AJ, Stone, IC Jr, Wendel, GD Jr. Sexual assault in postmenopausal women. Obstetrics and Gynaecology 1992; 80(5): 860–4.Google ScholarPubMed
Morgan, L, Dill, A, Welch, J. Sexual assault of postmenopausal women: a retrospective review. BJOG: An International Journal of Obstetrics and Gynaecology 2011; 118: 832–43.Google Scholar
Eckert, LO, Sugar, NF. Older victims of sexual assault: an underrecognized population. American Journal of Obstetrics & Gynecology 2008; 198: 688.e1–688.e7.Google Scholar
Baker, MW, Sugar, NF, Eckert, LO. Sexual assault of older women: risk and vulnerability by living arrangement. Sexuality Research & Social Policy 2009; 6(4): 7987.CrossRefGoogle Scholar
Ramsey-Klawsnik, H. Elder sexual abuse within the family. Journal of Elder Abuse and Neglect 2003; 15(1): 4358.CrossRefGoogle Scholar
Payne, BK. Understanding elder sexual abuse and the criminal justice system’s response: comparisons to elder physical abuse. Justice Quarterly 2010; 27: 206–24.CrossRefGoogle Scholar
Del Bove, G, Stermac, L, Bainbridge, D. Comparisons of sexual assault among older and younger women. Journal of Elder Abuse & Neglect 2005; 17: 118.CrossRefGoogle ScholarPubMed
Burgess, AW, Dowdell, EB, Prentky, RA. Sexual abuse of nursing home residents. Journal of Psychosocial Nursing & Mental Health Services 2000; 38: 1018.Google Scholar
Teaster, PB, Ramsey-Klawsnik, H, Mendiondo, MS, Abner, E, Cecil, K, Tooms, M. From behind the shadows: a profile of the sexual abuse of older men residing in nursing homes. Journal of Elder Abuse & Neglect 2007; 19: 2945.Google Scholar
Smith, D, Bugeja, L, Cunningham, N, Ibrahim, JE. A systematic review of sexual assaults in nursing homes. Gerontologist 2018; 58(6): e369e383.Google Scholar
Lea, SJ, Hunt, L, Shaw, S. Sexual assault of older women by strangers. Journal of Interpersonal Violence 26(11): 2303–20.Google Scholar
Clark, H, Quadrada, A. Insights into sexual assault perpetration: giving voice to victim/survivors’ knowledge. Australian Institute of Family Studies, Melbourne. 2010. www.aifs.gov.au/institute/pubs/resreport18/rr18.pdfGoogle Scholar
Fileborn, B. Sexual assault and justice for older women: a critical review of the literature. Trauma, Violence & Abuse 2017; 18(5): 496–50.Google Scholar
Mann, R, Horsley, P, Barrett, C, Tinney, J. Norma’s Project. A Research Study into the Sexual Assault of Older Women in Australia, ARCSHS Monograph Series No. 98. La Trobe University, Melbourne, Australia: Australian Research Centre in Sex, Health and Society; 2014.Google Scholar
Kim, SY, Karlawish, JH, Caine, ED. Current state of research on decision-making competence of cognitively impaired elderly persons. American Journal of Geriatric Psychiatry 2002; 10(2): 151–65.Google Scholar
Appelbaum, PS, Grisso, T. Assessing patients’ capacities to consent to treatment. New England Journal of Medicine 1988; 319(25): 1635–8.Google Scholar
Ramsey-Klawsnik, H, Brandl, B. Sexual abuse in later life. Sexual Assault Report July/August, 2009. www.civicresearchinstitute.com/sar.html.Google Scholar
Speck, P, Hartig, MT, Likes, W, et al. Case series of sexual assault in older persons. Clinics in Geriatric Medicine 2014; 30: 779806.Google Scholar
Ramin, S. Sexual assault in postmenopausal women. Primary Care Update for Obs/Gyn 1997; 4: 6570.CrossRefGoogle Scholar
Wyatt, J, Squires, T, Norfolk, G, Payne-James, J. Oxford Handbook of Forensic Medicine. Oxford: Oxford University Press; 2011, p. 352.CrossRefGoogle Scholar
Yen, K, Vock, P, Christe, A, et al. Clinical forensic radiology in strangulation victims: forensic expertise based on magnetic resonance imaging (MRI) findings. International Journal of Legal Medicine 2007; 121: 115–23.Google Scholar
MacFarlane, P, Stranz, C, Mackay, S. Missed laryngotracheal rupture leading to delayed presentation. Australian and New Zealand Journal of Surgery 2008; 78(11): 1030–1.Google Scholar
Becker, M, Leuchter, I, Platon, A, et al. Imaging of laryngeal trauma. European Journal of Radiology 2014; 83: 142–54.CrossRefGoogle ScholarPubMed
Morgan, L, Dill, A, Welch, J. Sexual assault of postmenopausal women: a retrospective review. BJOG: An International Journal of Obstetrics and Gynaecology 2011; 118: 832–43.Google Scholar
Eckert, LO, Sugar, NF. Older victims of sexual assault: an underrecognized population. American Journal of Obstetrics and Gynecology 2008; 198: 688.e1–688.e7.Google Scholar
Faculty of Forensic and Legal Medicine. Operational procedures and equipment for medical facilities in victim examination suites or Sexual Assault Referral Centres (SARCs). www.fflm.ac.uk/wp-content/uploads/2016/01/Operational-procedures-and-equipment-for-medical-facilities-in-victim-examination-suites-or-SARCs-Dr-M-Stark-Jan-2016.pdfGoogle Scholar
Margiotta, G, Tasselli, G, Tommolini, F, et al. Risk of DNA transfer by gloves in forensic case work. Forensic Science International: Genetics Supplement Series 2015; 5: e527e529.Google Scholar
Smith, DA, Webb, LG, Fennell, AI, et al. Early evidence kits in sexual assault: an observational study of spermatozoa detection in urine and other forensic specimens. Forensic Science, Medicine and Pathology 2014; 10(3): 336–43.Google Scholar
Saukko, P, Knight, B. Knight’s Forensic Pathology, 4th edn. Boca Raton, FL: CRC Press; 2016, p. 425.Google Scholar
The Faculty of Forensic and Legal Medicine. PICS Working Group Guidelines on Photography. 2017. https://fflm.ac.uk/wp-content/uploads/2018/01/PICS-Working-Group-Guidelines-on-Photography-Dr-Will-Anderson-May-2017.pdfGoogle Scholar
Lederer, T, Betz, P, Seidel, S. DNA analysis of fingernail debris using different multiplex systems: a case report. International Journal of Legal Medicine 2001; 114(4–5): 263–6.CrossRefGoogle ScholarPubMed
Terezhalmy, GT, Rilet, CK, Moore, WS. Oral lesions secondary to fellatio. Quintessence International 2000; 31(5): 361.Google Scholar
Nittis, M, Franco, M, Cochrane, C. New oral cut-off time limits in NSW. Journal of Forensic and Legal Medicine 2016; 44: 92–7.CrossRefGoogle ScholarPubMed
Saukko, P, Knight, B. Deaths associated with sexual offences. In Knight’s Forensic Pathology, 4th edn. Boca Raton, FL: CRC Press; 2016, p. 426.Google Scholar
Sweet, D, Lorente, M, Valenzuela, A, Vilanueva, E. An improved method to recover saliva for human skin: the double swab technique. Journal of Forensic Science 1997; 42(2): 230–2.Google Scholar
Pang, BCM, Cheung, BKK. Double swab technique for collecting touched evidence. Legal Medicine 2007; 9: 181–4.Google Scholar
The American Board of Forensic Odontology. Bitemark Methodology Standards and Guidelines. abfo.org/wp-content/uploads/2016/03/ABFO-Bitemark-Standards-03162016.pdfGoogle Scholar
Williams, S, Panacek, E, Green, W, et al. Recovery of salivary DNA from the skin after showering. Forensic Science, Medicine and Pathology 2015; 11(1): 2934.CrossRefGoogle ScholarPubMed
Saukko, P, Knight, B. Deaths associated with sexual offences. In Knight’s Forensic Pathology, 4th edn. Boca Raton, FL: CRC Press; 2016, p. 426.Google Scholar
Collins, K, Presnell, E. Neglect and the pathophysiology of aging. The American Journal of Forensic Medicine and Pathology 2007; 28(2): 157–62.Google Scholar
Zilkens, RR, Phillips, MA, Kelly, MC, et al. Non-fatal strangulation in sexual assault: a study of clinical and assault characteristics highlighting the role of intimate partner violence. Journal of Forensic and Legal Medicine 2016; 43: 17.Google Scholar
DiMaio, VJM, Dana, S. Handbook of Forensic Pathology, 2nd edn. Boca Raton, FL:Taylor and Francis;2007, p. 161.Google Scholar
Yen, K, Vock, P, Christe, A, et al. Clinical forensic radiology in strangulation victims: forensic expertise based on magnetic resonance imaging (MRI) findings. International Journal of Legal Medicine 2007; 121: 115–23.Google Scholar
Becker, M, Leuchter, I, Platon, A, et al. Imaging of laryngeal trauma. European Journal of Radiology 2014; 83: 142–54.Google Scholar
Scaglione, M, Romano, S, Pinto, A, et al. Acute tracheobronchial injuries: impact of imaging on diagnosis and management implications. European Journal of Radiology 2006; 59(3): 336–43.Google Scholar
Smock, B, Sturgeon, S. Recommendations for the medical/radiographic evaluation of acute adult, non-fatal strangulation. Training Institute on Strangulation Prevention. StrangulationTrainingInstitute.comGoogle Scholar
Jones, JS, Rossman, L, Diegel, R, Van Order, P, Wynn, BN. Sexual assault in postmenopausal women: epidemiology and patterns of genital injury. American Journal of Emergency Medicine 2009; 27: 922–9.Google Scholar
Muram, D, Miller, K, Cutler, A. Sexual assault of the elderly victim. Journal of Interpersonal Violence 1992; 7: 70–6.Google Scholar
Sommers, MS, Zink, T, Barker, RB, et al. Effects of age and ethnicity on physical injury from rape. Journal of Obstetric Gynecology and Neonatal Nursing 2006; 35: 199207.Google Scholar
Morgan, L, Dill, A, Welch, J. Sexual assault of postmenopausal women: a retrospective review. BJOG: An International Journal of Obstetrics and Gynaecology 2011; 118: 832–43.Google Scholar
Exline, DL, Smith, FP, Drexler, SG. Frequency of pubic hair transfer during sexual intercourse. Journal of Forensic Science 1998; 43: 505–8.Google Scholar
Speck, P, Kennedy, BL, Henry, ND, Ernst, EJ. Analysis of possible sexual assault or abuse in a 67-year-old female with early dementia post-brain attack. Advanced Emergency Nursing Journal 2013; 35(3): 217–39.Google Scholar
Sween, KRMS, Quarino, LA, Kishbaugh, JM. Detection of male DNA in the vaginal cavity after digital penetration using Y-chromosome short tandem repeats. Journal of Forensic Nursing 2015; 11(1): 3340.Google Scholar
Williams, S, Panacek, E, Green, W, et al. Recovery of salivary DNA from the skin after showering. Forensic Science, Medicine and Pathology 2015; 11(1): 2934.Google Scholar
Davies, A, Wilson, E. The persistence of seminal constituents in the human vagina. Forensic Science 1974: 3: 4555.Google Scholar
Casey, D, Domijan, K, MacNeill, S, et al. The persistence of sperm and the development of time since intercourse (TSI) guidelines in sexual assault cases at Forensic Science Ireland, Dublin. Journal of Forensic Science 2017; 62(3): 585–5.Google Scholar
The Forensic Science Service (UK). Technical update for forensic physicians on the use of lubricants. May 2006. www.fflm.ac.uk/wp-content/uploads/documentstore/1199899430.pdfGoogle Scholar
Loeve, A, Bilo, RA, Emirdag, E, et al. In vitro validation of vaginal sampling in rape victims: the problem of Locard’s principle. Forensic Science, Medicine and Pathology 2013; 9: 154–62.Google Scholar
Metsala, P, Nieninen, H. Traumatic lesions of the vagina. Acta Obstetricia et Gynecologica Scandinavica 1968; 47: 482–8.Google Scholar
Wilson, EM. A comparison of the persistence of seminal constituents in the human vagina and cervix. Police Surgeon 1982; 22: 44–5.Google Scholar
Speck, P, Ballantyne, J. Post-coital DNA Recovery Study. US Department of Justice Document No. 248682, March, 2015.Google Scholar
Wyatt, J, Squires, T, Norfolk, G, Payne-James, J. Oxford Handbook of Forensic Medicine. Oxford: Oxford University Press; 2011, p. 358.CrossRefGoogle Scholar
Cina, SJ, Collins, KA, Pettenati, MJ, Fitts, M. Isolation and identification of female DNA on post-coital penile swabs. American Journal of Forensic Medicine and Pathology 2000; 21: 97100.Google Scholar
Nittis, M, Stark, M. Evidence based practice: Laboratory feedback informs forensic specimen collection in NSW. Journal of Forensic and Legal Medicine 2014; 25: 3844.Google Scholar
Davies, A. Discussion of spermatozoa in the anal canal and rectum and in the oral cavity of female rape victims. Journal of Forensic and Legal Medicine 1979; 24: 541–2.Google Scholar
Wilson, GM, Allard, JE. Spermatozoa – their persistence after sexual intercourse. Forensic Science International 1982; 19: 135–54.Google Scholar
Janisch, S et al. Analysis of clinical forensic examination reports in sexual assault. International Journal of Legal Medicine 2010; 124(3): 227–35.Google Scholar
Poulos, C, Sheridan, D. Genital injuries in postmenopausal women after sexual assault. Journal of Elder Abuse & Neglect 2008; 20(4): 323–35.Google Scholar
Eckert, LO, Sugar, NF. Older victims of sexual assault: an underrecognized population. American Journal of Obstetrics and Gynecology 2008; 198: 688.e1–688.e7.Google Scholar
Ramin, SM, Satin, AJ, Stone, IC, Wendel, GD Jr. Sexual assault in postmenopausal women. Obstetrics and Gynecology 1992; 80: 860–4.Google Scholar
Sommers, MS, Zink, T, Barker, RB, et al. Effects of age and ethnicity on physical injury from rape. Journal of Obstetric, Gynecologic and Neonatal Nursing 2006; 35: 199207.Google Scholar
Sommers, M. Defining patterns of genital injury from sexual assault. Trauma Violence Abuse 2007; 8(3): 270–80.Google Scholar
Delacroix, J, Brown, J, Kadenhe-Chiweshe, A, et al. Rectal perforation secondary to rape and fisting in a female adolescent. Pediatric Emergency Care 2011; 27: 116–19.Google Scholar
Kovelman, I, Vey, E, Schober, J. Fatal anorectal trauma in the setting of sexual assault. American Journal of Forensic Medicine and Pathology 2010; 31(3): 273–7.Google Scholar
Cappelletti, S, Fiore, PA, Bottoni, E, Aromatario, M. Fourth-degree perineal laceration in nonconsensual fisting. American Journal of Forensic Medicine and Pathology 2017; 38(3): 258–2.CrossRefGoogle ScholarPubMed
United Nations Office on Drugs and Crime. Global Study on Homicide 2013. UNDOC; 2014. www.unodc.org/documents/data-and-analysis/statistics/GSH2013/2014_GLOBAL_HOMICIDE_BOOK_web.pdf (accessed November 5, 2019).Google Scholar
Terranova, C, Zen, M. Women victims of intentional homicide in Italy: new insights comparing Italian trends to German and US trends, 2008–2014. Journal of Forensic and Legal Medicine 2018; 53: 73–8.Google Scholar
Karakasi, M, Vasilikos, E, Voultsos, P, Vlachaki, A, Pavlidis, P. Sexual homicide: brief review of the literature and case report involving rape, genital mutilation and human arson. Journal of Forensic and Legal Medicine 2017; 46: 110.Google Scholar
Greenfield, L. Sex Offences and Offenders – An Analysis of Data on Rape and Sexual Assault. US Department of Justice. February, 1997. NCJ-163392.Google Scholar
Abrahams, N, Martin, LJ, Jewkes, R, et al. The epidemiology of suspected rape homicide in South Africa. Forensic Science International 2008; 178: 132–8.Google Scholar
Collins, K, Presnell, E. Elder homicide – a 20-year study. The American Journal of Forensic Medicine and Pathology 2006; 27(2): 132–8.Google Scholar
Fox, J, Levin, J. Homicide against the elderly: a research note. Criminologist 1991; 29: 317–27.Google Scholar
Safarik, M, Jarvis, JP, Nussbaum, KE. Sexual homicide of elderly females. Journal of Interpersonal Violence 2002; 17(5): 500–25.Google Scholar
Abrahams, N, Martin, LJ, Jewkes, R, et al. The epidemiology of suspected rape homicide in South Africa. Forensic Science International 2008; 178: 132–8.Google Scholar
Seleye-Fubara, D, Etebu, E. Postmortem findings of victims of sexual assault: a study of 15 autopsies in the Niger Delta Region of Nigeria. The Nigerian Postgraduate Medical Journal 2011; 18(4): 262–5.Google Scholar
Greenfield, L. Sex Offences and Offenders – An Analysis of Data on Rape and Sexual Assault. US Department of Justice. February, 1997. NCJ-163392.Google Scholar
Chan, HC, Heide, KH. Sexual homicide: a synthesis of the literature. Trauma Violence Abuse 2009; 10: 3154.CrossRefGoogle ScholarPubMed
Pollock, NL. Sexual assault of older women. Annals of Sex Research 1988; 1: 523–32.Google Scholar
Groth, A. The older rape victim and her assailant. Journal of Geriatric Psychiatry 1978; 2: 203–15.Google Scholar
Chan, HCO. Understanding Sexual Homicide Offenders: An Integrated Approach. Basingstoke, UK: Palgrave Macmillan; 2015.Google Scholar
Safarik, M, Jarvis, JP, Nussbaum, KE. Sexual homicide of elderly females. Journal of Interpersonal Violence 2002; 17(5): 500–25.Google Scholar
Luke, JL. The role of forensic pathology in criminal profiling. In Ressler, RK, Burgess, AW, Douglas, JE (eds.) Sexual Homicide – Patterns and Motives. Lexington, MA: Lexington Books; 1988, p. 154.Google Scholar
Wyatt, J, Squires, T, Norfolk, G, Payne-James, J. Oxford Handbook of Forensic Medicine. Oxford: Oxford University Press; 2011, p. 77.CrossRefGoogle Scholar
Byard, R, Langlois, N. Bruising: is it a case of “the more we know the less we understand”? Forensic Science, Medicine and Pathology 2015: 11: 479–81.CrossRefGoogle Scholar
Delteil, C, Tuchtan, L, Torrents, J, Capuani, C, Piercecchi-Marti, MD. Pediatric medicolegal autopsy in France: a forensic histopathological approach. Journal of Forensic and Legal Medicine 2018; 53: 106–11.Google Scholar
Collins, K, Bennett, A. Persistence of spermatozoa and prostatic acid phosphatase in specimens from deceased individuals during varied postmortem intervals. The American Journal of Forensic Medicine and Pathology 2001; 22(3): 228–32.Google Scholar
Saukko, P, Knight, B. Deaths associated with sexual offences. In Knight’s Forensic Pathology, 4th edn. Boca Raton, FL: CRC Press; 2016, p. 433.Google Scholar
Saukko, P, Knight, B. Deaths associated with sexual offences. In Knight’s Forensic Pathology, 4th edn. Boca Raton, FL: CRC Press; 2016, pp. 428–31.Google Scholar
Elam, R, Ray, VG. Sexually related trauma: a review. Annals of Emergency Medicine 1986; 15: 576–84.Google Scholar
Geist, R. Sexually related trauma. Emergency Medical Clinics of North America 1988; 6(3): 439–66.Google Scholar
Fain, D, McCormick, G. Vaginal “fisting” as a cause of death. The American Journal of Forensic Medicine and Pathology 1989; 10(1): 73–5.CrossRefGoogle Scholar
Orr, C, Clark, MA, Hawley, DA, et al. Fatal anorectal injuries: a series of four cases. Journal of Forensic Sciences 1995; 40(2): 219–21.Google Scholar
Cappelletti, S, Aromatario, M, Bottoni, E, et al. Variability in findings of anogenital injury in consensual and non-consensual fisting intercourse: a systematic review. Journal of Forensic and Legal Medicine 2016; 44: 5862.Google Scholar
Reay, D, Eisele, J. Sexual abuse and death of an elderly lady by “fisting.The American Journal of Forensic Medicine and Pathology 1983; 4(4): 347–9.Google Scholar
Rancati, A, Crudele, GD, Gentile, G, Zoja, R. The case of a prosthetic limb used to cause lethal intravaginal injuries: forensic medical aspects in a case of intimate partner violence. Forensic Science International 2014; 234: e21e24.Google Scholar
Ikeda, N, Hulewicz, B, Knight, B, et al. Homicide by rectal insertion of a walking stick. Nihon Hoigaku Zasshi 1991; 45: 341–4.Google ScholarPubMed
Kovelman, I, Vey, E, Scober, J. Fatal anorectal trauma in the setting of sexual assault. The American Journal of Forensic Medicine and Pathology 2010; 31(3): 273–7.Google Scholar
Calleja-Agius, J, Brincat, M, Borg, M. Skin connective tissue and ageing. Best Practice and Research in Clinical Obstetrics and Gynaecology 2013; 27(5): 727–40.Google Scholar
Raine-Feening, NJ, Brincat, MP, Muscat-Baron, Y. Skin aging and menopause: implications for treatment. American Journal of Clinical Dermatology 2003; 4: 371–8.Google Scholar
Calleja-Agius, J, Muscat-Baron, Y, Brincat, M. Skin ageing. Menopause International 2007; 13: 60–4.Google Scholar
Karadag, A, Parish, L, Lambert, W. Senile purpura as a stage of dermatoporosis. SkinMed 2017; 15: 91–2.Google Scholar
Kaya, G, Saurat, JH. Dermatoporosis: a chronic cutaneous insufficiency/fragility syndrome: Clinicopathological features, mechanisms, prevention and potential treatments. Dermatology 2007; 215: 284–94.Google Scholar
Word, RA, Pathi, S,. Schaffer, JI, et al. Pathophysiology of pelvic organ prolapse. Obstetrics and Gynecology Clinics of North America 2009; 36: 521–39.Google Scholar
Wines, N, Willsteed, E. Menopause and the skin. Australasian Journal of Dermatology 2001; 42: 149–60.Google Scholar
Swift, S, Woodman, P, O’Boyle, A, et al. Pelvic Organ Support Study (POSST): the distribution and epidemiologic condition of pelvic organ support defects. American Journal of Obstetrics and Gynecology 2005; 192: 795806.Google Scholar
Ulmsten, U. Urogenital ageing. Gerontology 1994; 40(Suppl 3): 68.Google Scholar
Farage, MA, Mailbach, HI. Morphology and physiological changes of genital skin and mucosa. Current Problems in Dermatology 2011; 40: 919.Google Scholar
Baggish, MS. Colposcopy of Cervix, Vagina and Vulva. A Comprehensive Textbook. Philadelphia: Mosby Press; 2003, p. 125.Google Scholar
Danesh, MJ, Chang, AL. The role of the dermatologist in detecting elder abuse and neglect. Journal of the American Academy of Dermatology 2015; 73: 285–93.Google Scholar
Langlois, NE, Gresham, GA. The ageing of bruises: a review and study of colour changes with time. Forensic Science International 1991; 50: 227–38.Google Scholar
Langlois, NE. The science behind the quest to determine the age of bruises – a review of the English language literature. Forensic Science, Medicine, and Pathology 2007; 3(4): 241–51.Google Scholar
Kocsard, E. Extravascular tissue factors in purpura. Australian Journal of Dermatology 1967; 9: 189–97.Google Scholar
Srivathsa, SH. Oral ecchymosis in elderly: senile purpura. Journal of Indian Oral Medicine and Radiology 2015; 27: 331–3.Google Scholar
Yoon, T, Kim, H, Kim, J, Kim, M, Lee, J. Bowen’s disease concealed by purpura. Journal of Dermatology 2007; 34: 65–7.Google Scholar
Jinna, S, Livingston, N, Moles, R. Cutaneous sign of abuse: kids are not just little people. Clinics in Dermatology 2017; 35: 504–11.Google Scholar
Fernandez, M, García, JCG, Paredes, BC, Blanco, AG, Rodríguez, AL. Spontaneous rupture of an axillary vein simulating elder physical abuse. Emergency Medicine Journal 2006; 23: 658.CrossRefGoogle ScholarPubMed
Byard, R, Langlois, N. Bruising: is it a case of “the more we know the less we understand”? Forensic Science, Medicine and Pathology 2015: 11: 479–81.Google Scholar
Tereskinski, G, Madro, R. Evidential value of injuries useful for reconstruction of the pedestrian-vehicle location at the moment of collision. Forensic Science International 2002; 128: 127–35.Google Scholar
Anderst, JD Carpenter, SL, Abshire, TC; Section on Hematology/Oncology and Committee on Child Abuse and Neglect of the American Academy of Pediatrics. Evaluation for bleeding disorders in suspected child abuse. Pediatrics 2013; 131(4): e1314–22.Google Scholar
Mosqueda, L, Burnight, K, Liao, S. The life cycle of bruises in older adults. Journal of the American Geriatrics Society 2005; 53(8): 1339–43.Google Scholar
Danesh, MJ, Chang, AL. The role of the dermatologist in detecting elder abuse and neglect. Journal of the American Academy of Dermatology 2015; 73: 285–93.Google Scholar
Wiglesworth, A, Austin, R, Corona, M, et al. Bruising as a marker of physical elder abuse. Journal of the American Geriatrics Society 2009; 57(7): 1191–6.Google Scholar
Beauregard, S, Gilchrest, BA. A survey of skin problems and skin care regimes in the elderly. Archives of Dermatology 1987; 123: 1638–43.Google Scholar
Ward, J, Bernhard, J. Willan’s itch and other causes of pruritus in the elderly. International Journal of Dermatology 2005; 44: 267–73.Google Scholar
Wyatt, J, Squires, T, Norfolk, G, Payne-James, J. Oxford Handbook of Forensic Medicine. Oxford: Oxford University Press; 2011, p. 119.Google Scholar
Clark, L, Black, J, Black, S. Skin tears. In Capezuti, EA, Siegler, EL, Mezey, MD (eds.) The Encyclopedia of Elder Care. New York, NY: Springer Publishing Company; 2008, p.72.Google Scholar
Chang, Al, Wong, JW, Endo, JO, Norman, RA. Geriatric dermatology review: major changes in skin function in older patients and their contribution to common clinical challenges. Journal of the American Medical Directors Association 2013; 14: 724–30.Google Scholar
Pearsall, C. Forensic biomarkers of elder abuse: what clinicians need to know. Clinical Forensic Nursing 2005; 1(4): 182–6.Google Scholar
Rosen, T, Bloemen, EM, LoFaso, VM, et al. Emergency department presentations for injuries in older adults independently known to be victims of elder abuse. Journal of Emergency Medicine 2016; 50(3): 518–26.Google Scholar
Grisius, M. Xerostomia. In Capezuti, EA, Siegler, EL, Mezey, MD (eds.) The Encyclopedia of Elder Care. New York, NY: Springer Publishing Company; 2008, p. 822.Google Scholar
Koutlas, I. Diseases of the oral cavity. In Wolff, K, Allen Johnson, R, Saavedra, A (eds.) Fitzpatricks Color Atlas and Synopsis of Clinical Dermatology, 7th edn. New York, NY: McGraw Hill Publishing; 2013, Chapter 38.Google Scholar
Yen, K, Vock, P, Christe, A, et al. Clinical forensic radiology in strangulation victims: forensic expertise based on magnetic resonance imaging (MRI) findings. International Journal of Legal Medicine 2007; 121: 115–23.Google Scholar
Christe, A, Thoeny, H, Ross, S, et al. Life-threatening versus non-life-threatening manual strangulation: are there appropriate criteria for MR imaging of the neck? European Radiology 2009; 19: 1882–9.Google Scholar
Shields, LB, Corey, TS, Weakley-Jones, B, Stewart, D. Living victims of strangulation: a 10-year review of cases in a metropolitan community. American Journal of Forensic Medicine and Pathology 2010; 31: 320–5.Google Scholar
DiMaio, VJM, Dana, S. Handbook of Forensic Pathology, 2nd edn. Boca Raton, FL: Taylor and Francis; 2007, p. 161.Google Scholar
Morgan, L, Dill, A, Welch, J. Sexual assault of postmenopausal women: a retrospective review. BJOG: An International Journal of Obstetrics and Gynaecology 2011; 118: 832–43.Google Scholar
Collins, K, Bennett, A. Persistence of spermatozoa and prostatic acid phosphatase in specimens from deceased individuals during varied postmortem intervals. The American Journal of Forensic Medicine and Pathology 2001; 22(3): 228–32.Google Scholar
Astrup, BS, Ravn, P, Lauritsen, L, et al. Nature, frequency and duration of genital lesions after consensual intercourse: implications for legal proceedings. Forensic Science International 2011; 219: 50–6.Google Scholar
Jones, J, Dunnuck, C, Rossman, L, Wynn, BN, Nelson-Horan, C. Significance of toluidine blue positive findings after speculum examination for sexual assault. American Journal of Emergency Medicine 2004; 22(3): 201–3.Google Scholar
White, C. Genital injuries in adults. Best Practice and Research in Clinical Obstetrics and Gynaecology 2013; 27: 113–30.Google Scholar
Geist, R. Sexually related trauma. Emergency Medical Clinics of North America 1988; 6(3): 439–66.Google Scholar
White, C. Genital injuries in adults. Best Practice and Research in Clinical Obstetrics and Gynaecology 2013; 27: 113–30.Google Scholar
Villot, A, Deffieux, X, Demoulin, G. Management of third and fourth degree perineal tears: a systematic review. Journal de Gynécologie Obstétrique et Biologie de la Reproduction (Paris) 2015; 44(9): 802–11.Google Scholar
Danesh, MJ, Chang, AL. The role of the dermatologist in detecting elder abuse and neglect. Journal of the American Academy of Dermatology 2015; 73: 285–93.Google Scholar
White, C. Genital injuries in adults. Best Practice and Research in Clinical Obstetrics and Gynaecology 2013; 27: 113–30.Google Scholar
Polaneczky, M. Atrophic vaginitis. In Capezuti, EA, Siegler, EL, Mezey, MD (eds.) The Encyclopedia of Elder Care. New York, NY: Springer Publishing Company; 2008, p. 71.Google Scholar
Wines, N, Willsteed, E. Menopause and the skin. Australasian Journal of Dermatology 2001; 42: 149–60.Google Scholar
Danesh, MJ, Chang, AL. The role of the dermatologist in detecting elder abuse and neglect. Journal of the American Academy of Dermatology 2015; 73: 285–93.Google Scholar
Leibowitch, M, Staunton, R, Neill, S, Barton, S, Marwood, R. An Atlas of Vulval Disease. A Combined Dermatological, Gynaecological and Venereological Approach. London: Martin Dunitz; 1997, p. 19.Google Scholar
Baggish, MS. Colposcopy of Cervix, Vagina and Vulva. A Comprehensive Textbook. Philadelphia: Mosby Press; 2003, p. 206.Google Scholar
Baskan, E, Turan, H, Tunali, S, Toker, SC, Saricaoglu, H. Open-label trial of cyclosporine for vulvar lichen sclerosus. Journal of the American Academy of Dermatology 2007; 57(2): 276–8.Google Scholar
White, C. Genital injuries in adults. Best Practice and Research in Clinical Obstetrics and Gynaecology 2013; 27: 113–30.Google Scholar
Geist, R. Sexually related trauma. Emergency Medical Clinics of North America 1988; 6(3): 439–66.Google Scholar
Neiger, A. Atlas of Practical Proctology. 2nd edn. Cambridge, MA: Hogrefe & Huber Publishers; 1990, p. 64.Google Scholar
Fileborn, B. Sexual assault and justice for older women: a critical review of the literature. Trauma, Violence & Abuse 2017; 18(5): 496–50.Google Scholar
Vierthaler, K. Best practices for working with rape crisis centers to address elder sexual abuse. Journal of Elder Abuse & Neglect 2008; 20(4): 306–22.Google Scholar
Lea, S, Lanvers, U, Shaw, S. Attrition in rape cases. British Journal of Criminology 2003; 43: 583–99.Google Scholar
Larcombe, W. Falling rape conviction rates: (some) feminist aims and measures for rape law. Feminist Legal Studies 2011; 19: 2745.Google Scholar
Cook, J, Dinnen, S, O’Donnell, C. Older women survivors of physical and sexual violence: a systematic review of the quantitative literature. Journal of Women’s Health 2001; 20(7): 1075–81.Google Scholar
Connolly, M, Breckman, R, Callahan, J, et al. The sexual revolution’s last frontier: how silence about sex undermines health, well-being, and safety in old age. Journal of the American Society on Aging 2012; 36(3): 4352.Google Scholar

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