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Guns and Dementia

By Susan Jeffrey
Medscape Medical News

July 21, 2014 (COPENHAGEN, Denmark) -- A new survey looks at access to guns by people with dementia. It finds that caregivers and family members of people being checked for problems with thinking didn't consistently remove guns from their homes or keep them locked up.

The study underlines the need for doctors to ask caregivers if they have guns in the home and, if so, advise them on safety measures to take, the researchers say.

In the United States, there is "a significant presence of firearms in the homes of patients with dementia, and many of these patients suffer from delusions and hallucinations, some of which can be paranoid, persecutory, or hostile," says Jason Hsieh, a medical student at Cleveland Clinic Lerner School of Medicine.

The results were presented at the Alzheimer's Association International Conference (AAIC) 2014.

Suicide, Homicide

In the U.S., 27% percent of people over the age of 65 own a firearm, Hsieh says. "In general, almost 40% of households in the U.S. contain a firearm, and surprisingly, in households with a firearm, the average number of firearms is 6.6," he says.

The elderly have the highest suicide rate of any part of the population, and firearms are the most common, as well as the most fatal, method of suicide. Data from the National Trauma Databank show that as people get older, the proportion of gun injuries that are self-inflicted rises. Other data show that as they age, people are less likely to survive a gunshot and less likely to return home after recovery.

"In addition to suicide, elderly individuals can be the victim of homicide, and this often happens from their caregiver," Hsieh says. "Most of these events happen at home, and again, just like suicide, using a firearm is the most common method."

Also, it's been shown that caregivers, families, and loved ones with dementia often don't remove guns from the home as the dementia gets worse, he says.

The concern comes from the fact that people with dementia more frequently behave aggressively than those without it. Increasing dementia is linked with worsening agitation and aggression, along with delusions – particularly, mistaking a person for someone else, he says.

Study Details

Included in this analysis were 495 people, with an average age of nearly 80. Most of the patients were women (63%).

Of the group, 378 (77%) qualified for a diagnosis of dementia, and 64% were already diagnosed with depression or qualified as depressed, the researchers say.

Of those with dementia, 46% had presumed Alzheimer's disease, 21% had vascular dementia, and 34% were classified as "other.”

Of the 378 people with dementia, 178 had delusions. Among them, 114 of the delusions were described as paranoid or persecutory (i.e. delusions that someone was stealing from them or other abuses).

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