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Affiliation
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University of Washington, Seattle, Washington (E.R.M., F.P.R., A.R.). |
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Abstract
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Background: Firearm access poses a danger to older persons with cognitive impairment; their families and caregivers; visitors, such as grandchildren; and potentially others. Given that 91% of firearm deaths among older U.S. adults in 2017 resulted among self-inflicted wounds, the well-established relationship between cognitive impairment and depression is particularly concerning in this population (1, 2). Those with dementia may also shoot themselves or others because of confusion or increased agitation and the associated aggression (3). Recent publications have encouraged clinicians to discuss with patients their own or their aging loved ones' access to firearms (4); however, little is known about the prevalence of household firearm ownership and storage practices among older adults.
Objective: To characterize adults aged 65 years or older residing in firearm-owning households and their firearm storage practices with regard to self-reported sociodemographic features, suicide risk factors, and confusion or memory loss. Data from the 2016 Washington State Behavioral Risk Factor Surveillance System (BRFSS) were used.
Methods and Findings: The BRFSS uses a complex survey design to gather representative estimates of various behaviors ( Appendix). We focused on alcohol consumption, mental health, and memory loss in addition to household firearm ownership and storage practices (Supplement). Storage was characterized in 3 mutually exclusive categories: all firearms stored locked and unloaded (the safest option), 1 or more firearms stored either unlocked and unloaded or locked and loaded, and 1 or more firearms stored unlocked and loaded (the least safe option). The analyses were conducted using Stata 15 (StataCorp). The Washington State Department of Health and University of Washington institutional review boards have determined that the BRFSS is exempt from review and approval.
A total of 5074 older adults responded. After exclusion of 581 who did not respond to the firearms module and 65 who reported household firearm ownership but did not report on storage, 4428 responses were available for analysis. Overall, 38.6% reported a firearm in the home (an estimated 410 000 statewide). Respondents from firearm-owning households tended to be younger and were more likely to be white, male, and married. Among firearm-owning households, 32.5% stored all firearms locked and unloaded, and 23.5% stored at least 1 firearm unlocked and loaded. Those reporting unlocked and loaded storage were more likely to be male, to be a veteran, and to reside in a rural area than those reporting safer storage.
The prevalence of diagnosed depression and frequent mental distress was 17.4% and 6.9%, respectively. Memory loss in the previous year was reported by 12.2% of participants, and 5.6% reported discussing it with a clinician. The prevalence of these conditions did not vary meaningfully by household firearm ownership (Table 2). Among those in firearm-owning households, the prevalence of suicide risk factors or memory loss did not vary meaningfully by storage practice.
Language: en |