Elder abuse is recognized internationally as a growing problem. Recent years have seen an increase in the number of authors recommending that the MDs systematically question old people concerning possible abuse. The aim of our study was to ascertain the extent of suspicion of elder abuse and the different types of abuse. We design a cross-sectional survey including 460 patients > or = 65 years at different health centers (South East Spain). A face-to-face interview and a physical examination was carried out. Extent of suspected abuse was 44.6%. Female sex, > or = 75 years, widowhood, living alone or with children, accommodation in house of relatives and income < or = 300 euros/month were the associated sociodemographic variables. The risk factors associated are recent worsening of health, living with a mentally ill person, excessive consumption of alcohol or illegal drugs, arguing frequently with relatives or the dependence on someone to carry out a daily activity. The signs in the physical examination associated are dehydration/malnutrition, pressure ulcers and poor body and/or mouth hygiene. There is a high extent of suspicion of elder abuse and the keyword in this respect is prevention.