Over a period of 1 year (December 2001 to December 2002), data were collected on 120 new cases of elder abuse and neglect, an incidence rate of approximately 0.5 percent. Five forms of elder abuse and neglect were included in the study: physical abuse (assault and deliberate infliction of physical pain and injuries); mental abuse (deliberate infliction of threats, humiliation, and fear); economic abuse (financial and material exploitation and fraud); sexual abuse (rape and other sexual acts); and neglect (the inability of an elderly person to care for herself/himself). Mental abuse was found to be the most prevalent types of abuse, and in most cases it included a combination of various forms of abuse and neglect. Alcoholism or drug abuse by a family member were related more to mental, economic, and physical abuse than neglect; and economic problems in the family tended to be linked to economic abuse of an elderly family member. Conflicts in family relationships pervaded most types of abusive behaviors. The elderly most at risk of abuse and neglect were unmarried women who were frail and disabled and living with others. Perpetrators of abuse and neglect ranged in age from 18 to 87. The vast majority were men, most of them married. Approximately one-fourth were the abused person's spouse. The multiplicity of modalities of elder abuse and the complexity of family problems underlying abuse and neglect suggests that this is a multifaceted and complex problem that requires the collaboration of an array of professionals and disciplines. 6 tables and 42 references