From a public health standpoint elder self-neglect is the most compelling form of elder mistreatment, which includes physical abuse, caregiver and self-neglect and financial exploitation. Self-neglect, the inability to provide for oneself the goods or services to meet basic needs is three times more common than physical abuse or caregiver neglect. Self-neglectors are vulnerable persons who have multiple deficits in a variety of social, functional and physical domains. It is the most commonly reported form of mistreatment; and an independent risk factor for death. The death rate for self-neglectors is two times that of persons never reported to adult protective services. The Texas Elder Abuse and Mistreatment Institute (TEAM) at Baylor College of Medicine (BCM) is the first state adult protective services-medical school collaboration in the US. TEAM has one of the largest direct care experiences with mistreated elders and is involved in a number of clinical, education and research projects. TEAM and other faculty from multiple BCM departments are forming a consortium to include the University of Houston Schools of Social Work, and the University of Texas Schools of Nursing and Public Health, the University of Texas Medical Branch (Galveston) and NASA called the Consortium for Research in Elder Self-neglect of Texas or CREST. Research in self-neglect is very limited. To increase understanding of self-neglect and lay the ground work for future intervention trials we have convened a diverse research group including: geriatricians, nurses, social scientists, epidemiologists, a statistician, a nutritional biochemist, a health economist and an immunologist. The specific aims are to 1.) Establish a case definition for self-neglect, 2.) Describe the phenotype of self-neglectors, and 3.) Develop the models to explain the relationships among physical, cognitive, and socioeconomic factors. To achieve these aims we will conduct three pilot studies to validate a Self-neglect Severity Scale, assess the feasibility of comprehensive nutritional assessment using NASA methodology and measure muscle strength and APO e4 in self-neglecting elders. We will also form three interdisciplinary working groups, convene a national research conference and appoint a national external advisory board to inform the CREST of elder needs.