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    Original Investigation
    July 15, 2020

    Views on Firearm Safety Among Caregivers of People With Alzheimer Disease and Related Dementias

    Author Affiliations
    • 1Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
    • 2Veterans Affairs Eastern Colorado Geriatric Research Education and Clinical Center, Denver
    • 3Harvard Injury Control Research Center, Harvard School of Public Health, Boston, Massachusetts
    • 4Department of Biostatistics and Informatics, School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
    • 5Division of Cardiology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
    • 6Adult & Child Consortium for Outcomes Research & Delivery Science, School of Medicine, University of Colorado Anschutz Medical Campus
    • 7Department of Emergency Medicine, Alpert Medical School, Brown University, Providence, Rhode Island
    • 8Department of Emergency Medicine, University of California, Davis, Sacramento
    • 9Division of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora
    • 10Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
    JAMA Netw Open. 2020;3(7):e207756. doi:10.1001/jamanetworkopen.2020.7756
    Key Points español 中文 (chinese)

    Question  What proportion of adults living in homes with firearms are caregivers for people with Alzheimer disease and related dementias, and what are their characteristics, experiences, and preferences related to firearms?

    Findings  In this survey study of US adults (aged ≥35 years) living in homes with firearms, 2.6% reported being caregivers of a person with Alzheimer disease and related dementias, and 41% of these caregivers lived with that person. Although most caregivers were open to health care professional counseling about firearm safety for persons with Alzheimer disease and related dementias, few caregivers had ever received any such counseling.

    Meaning  The findings suggest that many community-dwelling adults with dementia have firearm access and that there may be a need for enhanced education and resources for their caregivers.


    Importance  The population of adults with Alzheimer disease and related dementias (ADRD) is increasing, and many people with ADRD have access to firearms. Little is known, however, about how caregivers of people with ADRD think about or address firearm safety.

    Objective  To assess views on firearm safety risks among caregivers of persons with ADRD, experiences of caregivers with health care professional–delivered counseling, and their preferred sources of information about firearm safety.

    Design, Setting, and Participants  This survey study used a probability-based online survey (National Firearms Survey, July 30 to August 11, 2019) with weights used to generate nationally representative estimates of adults living in households with firearms to assess firearm safety views of English-speaking adults 35 years or older. Respondents for the National Firearm Survery were drawn from I KnowledgePanel, a frame with approximately 55 000 US adults selected on an ongoing basis using address-based sampling methods.

    Main Outcomes and Measures  Caregivers were asked whether the person with ADRD owned or had access to firearms. Additional ADRD-related measures assessed perceptions about the likelihood of types of firearm injuries involving people with ADRD, support for firearm safety counseling by health care professionals with regard to dementia, and history of ever having received such counseling.

    Results  Of 6712 invited panel members, 4030 completed the survey (completion rate, 65%). For this analysis, we excluded the youngest participants (aged 18-34 years; n = 498); among the remaining 3532 participants, 124 reported being caregivers for persons with ADRD. Of the 124 caregivers, 51% were female and the mean (SD) age was 60 (12.5) years. Most participants (71%; 95% CI, 69%-72%) thought that a person with ADRD was more likely to hurt someone else unintentionally than intentionally hurt themselves or someone else. Many participants thought health care professionals should always (45%; 95% CI, 43%-47%) or sometimes (34%; 95% CI, 32%-37%) talk about firearm safety with caregivers or patients with dementia, but only 5% of caregivers (95% CI, 2%-12%) reported that a health care professional had ever spoken to them about firearm safety. Among the 41% (95% CI, 31%-51%) of caregivers who lived with a person with dementia, 31% (95% CI, 18%-49%) said the person with dementia could access firearms in the home.

    Conclusions and Relevance  In this study, few caregivers of adults with ADRD reported having received health care professional counseling about firearm safety, although most thought health care professionals should provide such counseling. These findings raise concerns about home firearm access among adults with ADRD and indicate potential opportunities for enhanced education by health care professionals and community organizations.