Physical maltreatment accounted for 64.4 percent of cases, with adult children being perpetrators of 45.6 percent. Material abuse cases more frequently involved an adult child (36.5 percent) than a spouse (10.7 percent). Elders mistreated by spouses were more likely to be in poorer emotional health and to be more dependent on the abuser for companionship, financial resources and their management, and property maintenance. Spouse perpetrators were more likely to have recent and long-term medical complaints and have experienced a recent decline in health. Acts committed by adult children tended to be more severe and life threatening. These perpetrators were likely to have money problems and be financially dependent on their parents. Both perpetrator groups had a relatively high incidence of alcoholism and mental illness, although this was more apparent among adult children. Results suggest that the psychological state of the perpetrator, dependency, stress, and social isolation all contribute to elder abuse. Three case histories are provided and implications for practice are discussed. 10 tables and 24 references.