When Older Americans With Depression and Dementia Have Access to Firearms

A new study finds that older Americans with risk factors for harming themselves or others don't seem to be any less likely to have access to firearms than anyone else their age.
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A new study finds that more than one-fifth of seniors living with depression in a gun-owning household stores their firearms unlocked and loaded.

When it comes to gun violence in America, one solution politicians and citizens often talk about is better mental-health screenings. But a new study suggests there's little being done to mitigate the risks of gun ownership and unsafe gun storage among older Americans who have guns at home and might be especially prone to hurting themselves or others.

The study asked folks over 65 about whether they had firearms in their home, how they stored them, and whether they had certain mental-health symptoms such as depression, confusion, memory loss, and frequent mental distress. It found similar rates of these risk factors for suicide and harming others among households with and without firearms. It also found that rates of how those firearms are stored, whether locked and unloaded or unlocked and loaded, were similar among gun-owning and non-gun-owning households. For example, 16 percent of seniors living in homes with guns had a depression diagnosis, while about 18 percent of seniors living in homes without a gun had been diagnosed with depression. More than one in five seniors living with depression in a gun-owning household stored all of their firearms unlocked and loaded. Sixty-two percent of the households in the survey had guns. The data came from Washington State, the only state to collect such information.

"If we were doing a good job in promoting gun safety, you would expect that the prevalence of living in a home with a gun or unsafe storage would be lower when somebody's experiencing dementia or suicide risk factors, right?" says Ali Rowhani-Rahbar, an epidemiologist at the University of Washington who worked on the study. The fact that the study did not find any difference, he says, "indicates that many of the guidelines or recommendations so far have fallen short and we need to be much more active about promoting firearms safety."

The American Foundation for Suicide Prevention suggests that firearms be temporarily removed from people's homes when they're at risk for suicide and that, as a "secondary" measure, guns always be stored locked and unloaded. The weight of the evidence suggests—although it doesn't definitively prove—that access to guns increases suicides, likely because most suicide attempts are impulsive, and so if folks don't have access to the deadliest method, they have a better chance of surviving and getting help for their mental distress. Gun access could make big difference, especially, to senior men: Men over the age of 65 have the highest suicide rates in America, and firearms are the most common method.

The Alzheimer's Association recommends guns be removed entirely from the homes of people with Alzheimer's and other dementias. Folks with dementias often eventually lose their ability to recognize people and to make sound decisions, and experience depression. Dementias have no cure and only get worse over time.

The issue of older Americans and gun ownership gained some attention last year, when Kaiser Health News found and highlighted more than 100 cases of people with dementias shooting themselves or others to death since 2012, many of them declared incompetent to stand trial and seemingly unaware of what they had done. In addition, the statistics don't capture the number of people with dementias who threaten their family, neighbors, or home health aides with firearms, the story notes. Rowhani-Rahbar and his colleagues' study expands on the statistics that were available to the Kaiser journalists at that time.

Rowhani-Rahbar, who has a medical degree but doesn't see patients as a part of his job, wants to see doctors talk to their patients and their patients' families about gun access if they show signs of cognitive impairment or depression. He endorses an approach published last year, in which doctors suggested that people be increasingly restricted from accessing firearms as their dementia symptoms worsen, with no access for those with moderate to severe dementia (although those with light symptoms could work with their loved ones on a plan for the future).

This approach is roughly analogous to what most doctors recommend for people with dementia and driving. But not everyone agrees. Arthur Przebinda, a physician and representative for Doctors for Responsible Gun Ownership, told Kaiser Health News in 2018 that decisions about whether those with dementia can use guns should be left entirely to families. He didn't think the analogy to driving worked because driving isn't a right protected in the Constitution. Any kind of formal rules about dementia and firearms could lead to "a totalitarian system that decides when you can have rights and when you cannot," he said.

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