Older adults had a similar prevalence of suicide risk factors and memory loss regardless of whether they stored a firearm in the home, according to 2016 Behavioral Risk Factor Surveillance System (BRFSS) survey responses in Washington state.
Among 1,696 respondents ages 65 and older with firearms in the home, 32.5% said they always kept them locked and unloaded, while 23.5% reported keeping at least one unlocked and loaded (23.5%), according Erin Morgan, MS, of the University of Washington in Seattle, and colleagues.
Many of these same individuals reported memory loss in the previous year (12.2%), diagnosed depression (17.4%), or frequent mental distress (6.9%); rates did not vary according to gun storage habits, Morgan and colleagues wrote in Annals of Internal Medicine.
“These findings indicate a gap in suicide and injury prevention efforts,” Morgan told MedPage Today in an email. “Ideally, depressive symptoms and memory loss would be less common among individuals from firearm-owning households.”
Federal law prohibits the selling of firearms or ammunition to people adjudicated as mentally ill or who have been involuntarily committed to a psychiatric hospital. Fourteen states and the District of Columbia have enacted Red Flag laws, which allow immediate family members and law enforcement to intervene when a person is considering suicide or other acts of violence, but does not fall under the categories outlined in federal law. Morgan and colleagues suggested older adults with memory loss should perhaps be considered within this realm.
“Federally, unless someone has been found incompetent by a court, there are very limited restrictions,” Morgan explained. “Some states have created additional limitations, but only two have specifically cited dementia as disqualifying someone from making a purchase.”
On the other hand, there are no state or federal laws that prohibit physicians from discussing firearm storage habits with their patients, and some professional organizations, like the Alzheimer’s Association, have published guidelines about how to appropriately do so, said Marian Betz, MD, MPH, of the University of Colorado, who was not involved in the Washington study.
“There are recommendations that clinicians should be asking, but they’re not requirements and I think in a lot of places it’s probably not universal yet in part because clinicians might not know how to ask, they may not know what to say, what the options are, or how to think through all of that,” Betz said.
“My perspective is, when we’re thinking about this issue, ideally it would encourage people to have these conversations earlier, to make plans for what they would want done with their firearms when they eventually pass away or if they develop dementia,” she added.
The survey asked respondents via postal mail or telephone whether firearms were in the house and, if so, how they were stored: all kept locked and unloaded; at least some either unlocked and unloaded or locked and loaded; and at least one unlocked and loaded.
Morgan and her team found 38.6% of respondents reported having at least one firearm in the home, in line with estimates from other surveys that one-third of U.S. adults live in firearm-owning households. Nationally, 46% of gun owners store their guns locked and inactive, while more than half are estimated to keep at least one gun without any protective measures, according to 2016 data reported in the American Journal of Public Health last year.
In the Washington study, gun owners were more likely than non-gun owners to be white (91.4% vs 84.5%), male (61.2% vs 34.5%), and married (69% vs 49.2%), and they also tended to be younger, the authors reported. The two groups were similar in terms of annual income and education level. Some 37% of gun-owning seniors were veterans and nearly half of them kept at least one gun loaded and unlocked.
Older adults with firearms in the home tended to report drinking more alcohol than non gun-owners, with slightly higher percentages of the former group reporting binge alcohol use (6.9% vs 4.5%), and chronic alcohol use (5.7% vs 4.3%).
Morgan noted, as a study limitation, that older adults with cognitive impairments may be less likely to complete the questionnaire. She also said hearing loss may have hindered completion of telephone surveys.
Morgan did not report any relevant disclosures.
Co-authors reported receiving grants outside this work from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the Laura and John Arnold Foundation, the City of Seattle, and the U.S. Department of Justice.
The study was funded by Grandmothers Against Gun Violence. Data from the survey were made available by the Washington State Department of Health, the Center for Health Statistics, the Behavioral Risk Factor Surveillance System, and the CDC; and firearm-related questions were funded by the Clark County Public Health, the Kitsap Public Health District, the Public Health — Seattle & King County, the Snohomish Health District, the Spokane Regional Health District, the Tacoma-Pierce County Health Department, and the Washington State Department of Health.