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Invited Commentary
July 15, 2020

Firearm Safety in an Aging United States

Author Affiliations
  • 1Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington
  • 2Firearm Injury and Policy Research Program, Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington
JAMA Netw Open. 2020;3(7):e2011182. doi:10.1001/jamanetworkopen.2020.11182

The population of the United States is growing older and people are living longer than ever before. With these increases in life expectancy, health concerns such as Alzheimer disease and related dementias (ADRD) are becoming more prevalent. The existent literature suggests that persons with dementia (PWD) may be at high risk for self-harm or aggressive behavior toward others1,2; however, less is known about how these behaviors may further increase the risk of self or inter-personal harm when juxtaposed with firearm access among older adults.3

In their article published this week in JAMA Network Open, Betz and colleagues4 highlight PWD and their caregivers as an important, but understudied, group of individuals who own or have access to firearms and are potentially at high risk for injury incidents. Caregivers for PWD were surveyed only if they resided in a firearm-owning household. Authors delve into practical and timely questions, such as the frequency by which providers are discussing firearm safety with caregivers and the knowledge among caregivers for PWD about risk for firearm injury.4 The authors have done a commendable job in beginning to estimate the proportion of residents of firearm-owning households who are providing care to PWD—some of whom also have access to household firearms. They found that among caregivers who cohabitate with PWD in firearm-owning homes, 31% of caregivers reported that the PWD could access a gun. Over 80% of caregivers agreed that there are times when it is appropriate for health care professionals to discuss firearms with patients in the context of ADRD, and nearly 65% of caregivers reported that they had looked or would look to health care professionals for information about firearm safety; nonetheless, very few caregivers reported a health care practitioner ever broaching the subject.4 The lack of dialogue between patients, caregivers, and clinicians may at least partially explain why of the 11% of caregivers who expressed concerns about PWD having firearm access, only 53% reported that they or family and friends acted on that concern.4

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