Firearms and dementia: a smoking gun?

Author: Lynch CA / Moran M / Lawlor BA
Publication: Int J Geriatr Psychiatry
Topics: Age Group Legislation and Policy Ownership Mental Health
Keywords: Aged Cognition Disorders/etiology Dementia/diagnosis/ psychology Firearms/legislation & jurisprudence Risk Assessment/methods
Bibliographic information +

Compared to psychiatric illnesses, which are generally relapsing and remitting, dementias are characterized by progressive cognitive and functional decline and often involve behavioral and psychological symptoms which “should prompt risk assessment” by caregivers for individuals with dementia who have access to a gun. However, dementia, particularly in its early stages, can be difficult to detect and “issues of safety must be balance against the rights and freedoms of the individual.” This editorial summarizes gun ownership laws in Great Britain, Canada and Australia and summarizes rates of dementia and mild cognitive impairment, gun ownership, gun homicide and gun suicide in these countries. The authors propose a set of clinical guidelines and a decision tree with which to assess the risk of firearm use among older persons. The proposed recommendations include: 1) clinicians should be knowledgeable about local regulations regarding gun ownership, 2) cognitive impairment “should be considered relevant in the granting or refusal of a firearms license,” 3) clinicians should ask patients with dementia or mild cognitive impairment or their caregivers about access to firearms and gun ownership as part of routine safety assessments, 4) people with dementia should not be allowed unsupervised access to firearms and should be prohibited from firearms ownership, 5) the risk of people with mild cognitive impairment relative to firearms should be routinely assessed, 6) the firearms licenses of people with diagnosed mild cognitive impairment should be kept under review, 7) routine screening for dementia and mild cognitive impairment should be considered as a component of the application process for firearms ownership.