Extreme Risk Protection Orders in Older Adults in Six U.S. States: A Descriptive Study.

IF 2.6 3区医学 Q3 GERIATRICS & GERONTOLOGY Clinical Gerontologist Pub Date : 2024-07-01 Epub Date: 2023-09-09 DOI:10.1080/07317115.2023.2254279

Marian E Betz, Shannon Frattaroli, Christopher E Knoepke, Rachel Johnson, Annette Christy, Julia P Schleimer, Veronica A Pear, Megan McCarthy, Reena Kapoor, Michael A Norko, Ali Rowhani-Rahbar, Wenjuan Ma, Garen J Wintemute, Jeffrey W Swanson, April M Zeoli

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Abstract

Objectives: Extreme Risk Protection Orders (ERPOs) allow a court to restrict firearm access for individuals ("respondents") at imminent risk of harm to self/others. Little is known about ERPOs use for older adults, a population with higher rates of suicide and dementia.

Methods: We abstracted ERPO cases through June 30, 2020, from California, Colorado, Connecticut, Florida, Maryland, and Washington. We restricted our analysis to petitions for older (≥65 years) respondents, stratified by documented cognitive impairment.

Results: Among 6,699 ERPO petitions, 672 (10.0%) were for older adults; 13.7% (n = 92) of these noted cognitive impairment. Most were white (75.7%) men (90.2%). Cognitively impaired (vs. non-impaired) respondents were older (mean age 78.2 vs 72.7 years) and more likely to have documented irrational/erratic behavior (30.4% vs 15.7%), but less likely to have documented suicidality (33.7% vs 55.0%). At the time of the petition, 56.2% of older adult respondents had documented firearm access (median accessible firearms = 3, range 1-160).

Conclusions: Approximately 14% of ERPO petitions for older adults involved cognitive impairment; one-third of these noted suicide risk. Studies examining ERPO implementation across states may inform usage and awareness.

Clinical implications: ERPOs may reduce firearm access among older adults with cognitive impairment, suicidality, or risk of violence.

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美国六个州老年人的极端风险保护令：描述性研究。

目标：极端风险保护令（ERPOs）允许法院限制面临伤害自己/他人的紧迫风险的个人（"受访者"）使用枪支。关于老年人使用ERPO的情况知之甚少，而老年人是自杀率和痴呆症发病率较高的人群：我们从加利福尼亚州、科罗拉多州、康涅狄格州、佛罗里达州、马里兰州和华盛顿州摘录了截至 2020 年 6 月 30 日的 ERPO 案例。我们的分析仅限于老年（≥65 岁）受访者的申请，并根据有记录的认知障碍进行了分层：在 6,699 份 ERPO 申请中，有 672 份（10.0%）是针对老年人的；其中 13.7%（n = 92）有认知障碍。大多数为白人（75.7%）和男性（90.2%）。有认知障碍（与无认知障碍）的受访者年龄更大（平均年龄为 78.2 岁对 72.7 岁），更有可能有非理性/反常行为记录（30.4% 对 15.7%），但有自杀记录的可能性较小（33.7% 对 55.0%）。在提出申请时，56.2% 的老年受访者有使用枪支的记录（可使用枪支的中位数 = 3，范围为 1-160）：约有 14% 的老年人《限制枪支使用条例》申请涉及认知障碍；其中三分之一的申请指出了自杀风险。对各州ERPO实施情况的研究可为使用和认识提供参考：临床意义：ERPO 可减少有认知障碍、自杀倾向或暴力风险的老年人获得枪支的机会。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Gerontologist GERIATRICS & GERONTOLOGY-PSYCHIATRY

CiteScore

6.20

自引率

25.00%

发文量

审稿时长

>12 weeks

期刊介绍： Clinical Gerontologist presents original research, reviews, and clinical comments relevant to the needs of behavioral health professionals and all practitioners who work with older adults. Published in cooperation with Psychologists in Long Term Care, the journal is designed for psychologists, physicians, nurses, social workers, counselors (family, pastoral, and vocational), and other health professionals who address behavioral health concerns found in later life, including: -adjustments to changing roles- issues related to diversity and aging- family caregiving- spirituality- cognitive and psychosocial assessment- depression, anxiety, and PTSD- Alzheimer’s disease and other neurocognitive disorders- long term care- behavioral medicine in aging- rehabilitation and education for older adults. Each issue provides insightful articles on current topics. Submissions are peer reviewed by content experts and selected for both scholarship and relevance to the practitioner to ensure that the articles are among the best in the field. Authors report original research and conceptual reviews. A unique column in Clinical Gerontologist is “Clinical Comments." This section features brief observations and specific suggestions from practitioners which avoid elaborate research designs or long reference lists. This section is a unique opportunity for you to learn about the valuable clinical work of your peers in a short, concise format.