**1. Introduction**

SARS-CoV-2 is a new single-stranded RNA beta-coronavirus. It first appeared in November 2019 in Wuhan, China. In Poland, the first case was recorded on 4 March 2020. The World Health Organization (WHO) named this disease COVID-19. Moreover, on 11 March 2020, WHO announced the beginning of the COVID-19 pandemic [1]. Coronavirus disease is associated with threats to the health and life of people all over the world, not only because of the disease itself, but also its complications. This pandemic has led to a real revolution in everyday life. In order to limit its spread, it was necessary for the state to introduce isolation, the need to maintain social distance, and also to control the behaviour of citizens. Further more, change in everyday life, economic instability, loss of job, fear of illness, social distance, and complications after illness are factors that may contribute to the occurrence of neuropsychiatric disorders, including symptoms of anxiety

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**Citation:** Filipska, K.; Biercewicz, M.; Wi´sniewski, A.; Jabło ´nska, R.; Królikowska, A.; Główczewska-Siedlecka, E.; K ˛edziora-Kornatowska, K.; Slusarz, R. ´ High Rate of Elder Abuse in the Time of COVID-19—A Cross Sectional Study of Geriatric and Neurology Clinic Patients. *J. Clin. Med.* **2021**, *10*, 4532. https://doi.org/10.3390/ jcm10194532

Academic Editor: Michele Roccella

Received: 7 September 2021 Accepted: 28 September 2021 Published: 30 September 2021

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**Copyright:** © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).

and depression, which has been observed among the society of many countries affected by the pandemic [2,3].

Another important effect of the pandemic is the increase in the rates of violence, including in relation to the elderly [4]. Most of the older adults who become victims of violence are people who require long-term and increased care [4–6]. The stress theory describes caring for the elderly as a difficult and stressful activity [5]. In addition, especially during the COVID-19 pandemic, there are pressures and stresses related to work and life. All these factors contribute to an increase in the rates of violence against the elderly by caregivers. In addition, isolation itself is also a significant risk factor for abuse. Elderly or dependent people can often only interact with their perpetrators or due to quarantine, stay only with them [4–6].

Elder abuse (EA) (also known as mistreatment, older adult abuse or maltreatment) is defined by the WHO as "a single or repeated act or lack of appropriate action, occurring within a relationship of trust, which causes harm or distress to an older person". According to WHO, we distinguish five types of EA: physical, sexual, psychological, and emotional abuse, financial and material abuse, abandonment, and neglect [7]. On the other hand, the most common form of EA is psychological abuse [7–9]. It should be noted, however, that older adult abuse is a global public health problem, and the estimated total prevalence rate is 15.7% [10]. It is believed, however, that the ongoing COVID-19 pandemic caused a sharp increase in the incidence of EA, including as a result of isolation and social distance in combination with increased interpersonal stressors [11,12]. Our research team has already conducted cross-sectional research on elder abuse from April 2017 to January 2019. It has been shown then that among 200 respondents 38.5% of older people have experienced abuse [13]. Observing the current indicators, it can be easily noticed that there has been a sharp increase in acts of of EA during the COVID-19 pandemic. Thus, there is a strong need for research on the scale and severity of the incidence of EA and emotional distress, including symptoms of depression and generalized anxiety, in different countries.

In summary, the aim of this study was to determine the elder abuse rates and identification of the most common risk factors of mistreatment in the Polish population in a hospital setting during the COVID-19 pandemic.
