*2.1. Study Design and Participants*

From October 2020 to August 2021, we conducted this cross-sectional study in the Department of Neurology and Department of Geriatrics at University Hospital No. 1 in Bydgoszcz, Poland. The study included people who met the inclusion criteria: aged 65 years and older, voluntarily agreed to participate, with sufficient speech, hearing, and cognitive abilities: no dementia or Alzheimer's disease diagnosed by a psychologist or physician. The total population of the respondents was 347.

After admission to the ward, each patient underwent psychological and neurological assessment in order to exclude cognitive impairment and dementia. The standard tool used by the psychologists in Poland is the Montreal Cognitive Assessment test and Mini-Mental State Examination and the Clock Drawing Test. All patients who met the inclusion criteria became participants in this study. As scheduled admissions were on hold for a long time during the COVID-19 pandemic, hospitals operated on an ER, and the number of hospitalized patients was very limited. Access to other hospitals was also restricted. Thus, we were able to collect only such a group of respondents.

Due to the fact that the study was conducted during the epidemic, we took special precautions. The subjects were patients of two departments: the Department of Neurology and Department of Geriatrics at University Hospital No. 1 in Bydgoszcz. Consequently, we spoke to each test person alone in a separate room. All test persons prior to admission to the hospital tested negative for SARS-CoV-2. Each of the study participants and the researchers wore masks. During the meeting, a distance of at least 2 meters was kept. In addition, all completed questionnaires were placed in a specially prepared box, where they

had a grace period of about 7 days. Each of the participants completed the questionnaires independently. In the event of any questions or doubts, the researcher was at his disposal.

### *2.2. Variables and Measurements*

Before the start of the project, a pilot study was carried out on a group of 46 people in order to obtain information on the understandability of the questions included in the Authors-Designed Questionnaire (ADQ). All comments, opinions and suggested changes have been considered. Therefore, we have removed or changed some text items to the final, easy-to-understand form. The results of the pilot studies were not included in the results of this work.

The dependent variables include: elder abuse: psychological, physical, sexual and economic abuse and the risk of EA. The definitions of these variables were:


In addition to the VASS scale, the study also used: ADQ, the Geriatric Depression Scale (GDS) 15 items [17,18] and the Activities of Daily Living (ADL) Scale [19,20]. ADQ was created specifically for the purpose of this study, as no gold standard tool for assessing elder abuse has been published in Poland so far. This tool was developed on the basis of the researcher's own experience in conducting this type of research and the available literature [9,10,13,21,22]. The reliability of the ADQ was examined by computing internal consistency coefficients. The Cronbach alpha coefficient was 0.91. Sociodemographic questions were included in the 1st part of the questionnaire and concerned: sex, age, education, marital status, family income, and place of residence. The leading question was "During the COVID-19 pandemic, have you experienced any abuse (e.g. kicking, pulling, hitting, ridiculing, pushing, insulting) in your place of residence?". As for the various forms of EA, the respondents answered the question: "Which of the following forms of elder abuse were used against you?" selecting from the list of the abuses they have experienced. Above, in the definition of each type of violence, we have listed all the acts characteristic of a given sub-type of abuse, which were included in the ADQ. The next questions concerned, among others: the occurrence of chronic diseases, assessment of one's health condition, feeling lonely, depressed or anxious, and having children.
