In the United States the debate around gun ownership often focuses on teenagers; however, research shows that elderly Americans are the most likely to own a gun and that presents both medical and legal problems for physicians and carers.

Writing in the Journal of the American Geriatrics Society, Dr. Ellen Pinholt explores these issues and proposes a series of 'red flag' questions which caregivers must ask.

While there is no upper age limit on owning a firearm, Americans aged over 65 have the highest prevalence of dementia, depression and suicide. Federal law prohibits mentally incompetent persons from possessing a gun; however, this only applies to a formal finding by a court and not necessarily to a physician's diagnosis of dementia.

Using a series of case studies to explore the medical and legal dimensions of the issue, Dr Pinholt suggests '5 L's', questions about gun ownership which should be asked as routinely as questions about driving.

If there is a gun present is it Locked? Is it Loaded? Are Little children present? Does the gun owner feel Low? Is the gun owner Learned?