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Introduction: The Consortium for Research in Elder Self‐Neglect

Elders who neglect themselves are often frail and have multiple, untreated medical illnesses and some level of cognitive impairment. For the most part, these elderly people lack access to or refuse needed support services and, as a result, frequently live in squalor, with advanced, untreated diseases. Elder self-neglect is the most commonly reported form of elder mistreatment and, thus, is reported more often than physical abuse, caregiver neglect, and financial exploitation. The majority of self-neglecting elderly people come to medical attention despite the associated high mortality. Although self-neglect was first described in the 1960s, the precipitating factors (host, environment), the pathophysiology, and the medical and socioeconomic sequelae are poorly understood. Research on elder self-neglect has been limited for a variety of reasons. This research lags primarily because the needs of this population are complex and diverse and encompass interrelated medical, psychiatric, economic, social, and functional problems. Thus, this area of research is especially challenging. Despite these difficulties, self-neglect is a serious and burgeoning public health problem, and effective research in this field necessitates the collective efforts of a highly evolved interdisciplinary team. In 1997, the geriatrics faculty at Baylor College of Medicine established an interdisciplinary team (Texas Elder Abuse and Mistreatment (TEAM) Institute) to study elder mistreatment. Subsequently, the findings of the TEAM Institute led to the investigation of self-neglect as a critical category of reported elder mistreatment. In 2003, the National Institutes of Health (NIH) Roadmap, which is an innovative approach designed to accelerate fundamental discovery and translate the findings into effective prevention strategies and new treatments, was begun. The strategic initiatives funded under the NIH Roadmap address critical roadblocks and gaps in knowledge that currently constrain progress in biomedical research. In the fall of 2004, as part of the NIH Roadmap for Medical Research, more than $36 million was awarded for a 3-year period to fund 21 Exploratory Centers for Interdisciplinary Research. The Consortium for Research in Elder SelfNeglect of Texas (CREST) is one of the centers that this initiative funded. CREST is currently housed at the University of Texas Medical School in Houston. With this grant, CREST proposed to attain four broad goals: