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Gambling among elderly - European Association for the Study of ...

Gambling among the elderly:

a literature review

Laurence Aufrère

Clinical psychologist, cognitive therapy

www.jeu-responsable.ch

laufrere@gmail.com

EASG congress Loutraki, Greece

19.9.2012


Key points

• Predictors of gambling behavior

• Perceived motivations for gambling

• Types of gambling preferred

• Gender and gambling

• Comparison with younger adults

• Positive consequences of gambling

• Excessive gambling

• Limits of the studies

• Conclusion


Gambling behavior:

why senior citizens are another

group of interest?

• They have free time at their hands

• They often don’t work or don’t earn money

• They are attracted by pleasure and money

• They are often in good health

• They have money to spend

• They are a group specificly targeted by the

gaming industry

• They can develop excessive gambling

BUT few studies have investigated seniors’

gambling behaviors


Gambling behavior among

the elderly

Gambling is a common activity

among elderly coming from the

general population (Wiebe &

Cox, 2005) or from Health

Centers (Levens & al, 2005)

Gambling activity tends to

decrease with age (Stitt,

Giacopassi & Nichols, 2000)


Predictors of gambling (1)

Vander Bilt, Dogde, Pandav, Shaffer &

Ganguli (2004)

• Cross-sectional study: gambling is

related to

• youngest age of the elderly (70-79)

• men

• low level of education

• high social support

• low level of depression

• self-reported better health

• alcohol use in the previous year

• high level of cognitive functionning


Predictors of gambling (2)

Vander Bilt, Dogde, Pandav, Shaffer &

Ganguli (2004)

• Longitudinal study: prediction of

gambling activity over an eight

years time course

• youngest age of elderly (70-79)

• men

• high social support

• alcohol use

• gambling activity in the past


Motivation for gambling

• Related more to the need of stimulation

and to escape from boredom than to win

money (Desai & al., 2004)

• Relaxing, entertainment, escape for the

day or from boredom, spending time is

related to Casino or bingo gambling (Neilly

& Burke, 2000)

• Casino gambling is related to getting a

cheap meal (Neilly & Burke, 2000)


Motivation for gambling : non

problematic vs problematic

gamblers

• NPG visit casinos for entertainment, meeting

friends, having meal, seeing a show (Hope &

Havir, 2002)

• Women NPG gamble more for entertainment

(Hope & Havir, 2002)

• Men NPG gamble more for the money, out of

curiosity & to occupy themselves (Hope &

Havir, 2002)

• PG, specially for women, gamble to release

stress and to avoid boredom

• PG gamble for money but also for

entertainment, escape stress and depression

(Southewell & al., 2008)


Preference type of

gambling

• Non-strategic gaming (Nower &

Blaszczynski, 2008) as for pathological

gamblers who started gambling > 55

years old (Grant & al., 2009)

• Slot machine and bingo (Mc Neilly &

Burke, 2000 & 2001) main source of

problem gambling for old people

(Potenza & al., 2006)


Gender and type of

gambling

• Old women gamble significantly

more than old men (Still &

al.,2003; Mc Neilly & Burke,

2000)

• Women prefer EGM or gambling

(lotteries, slot or bingo) (Mc

Kay, 2005)

• Higher risk to develop gambling

problem (Mc Kay, 2005)


Type of gambling:

comparison with younger

adults

• Elderly gamble more frequently (Stitt

& al, 2003; Clarke, 2008; Desai & al,

2004) especially if they have their

own autonomy and mobility (Mc

Neilly & Burke, 2000)

• Elderly gamble with significantly

less money (Stitt & al., 2003) but

they can spend as much (Moufakkir,

2006) even with a lower income


Positive consequences of

gambling among elderly

• Recreational gambling (RG) is related to

positive measure of health and wellbeing

(Desai & al., 2004)

• RG ≥ 65 y.o. have the highest level of

« good and excellent subjective general

health » from all the RG ≥ 18 y.o. (Desai &

al., 2004)

• RG is associated to more men (Desai & al.,

2004)

• RG is related to the development of

cognitive and behavioral strategy (Hagen &

al., 2005), preventing from pathological

gambling (Hagen & al., 2005)


Comparison: RG and non

gamblers among elderly

• RG have signif. more life-time

diagnoses of alcohol and tabacco

addiction; anxiety, affective and

personality disorder; obesity

(Pietrzak & al., 2006)

• RG have signif. less past-year

diagnosis of arteriosclerosis or

hepatic cirrhosis (Pietrzak & al.,

2006)


Excessive gambling

among elderly (1)

• Prevalence differ depending on the studies

• In general population, similar rate as adults

from industrialized countries

• Related to psychological and physical health

problem (Mc Neilly & Burke, 2000; Zaranek &

Lichtenberg, 2008). Health pb can continue

even after abstinence (Erikson & al., 2005)

• PG have signif. more physical or psychological

health problems than RG (Erickson & al., 2005)

• Possibly devastating dammage with less

ressources to recover and more reluctance to

ask for help (Nixon & al., 2005) especially in

women (Mc Kay, 2005)


Excessive gambling

among elderly (2) : comparison with

youngest adults

• Develop less pb gambling (Desai & al.,

2004; Clarke, 2008)

• Develop lower repertoir of types of

problem gambling (Potenza & al., 2006)

• Develop lower anxiety (Potenza & al.,

2006), except if they develop

pathological gambling in the advanced

age(≥ 55 y.o.)

• Experiment less negative consequences

and have less pb with illicit drugs

(Potenza & al., 2006) than young adult

excessive gamblers. Nevertherless they

have similar problem with alcohol

(Potenza, 2006)


Profile of problematic gamblers

among the elderly

• Zaranek & Lichtenberg (2008)

• man

• widowed

• income


Gambling: a threat to the

elderly?

• No threat for the majority of elderly

(Hope & Harvir, 2002); Hagen, Nixon

& Solowoniuk, 2005; Stitt & al.,

2005; MoufaKkir, 2006)

• Some authors are concerned

because of low income and possible

vulnerability

• No systematic screening of problem

gambling in geriatric-psychiatry (Mc

Neilly & Burke, 2002)


Limitations of these

studies

• Usage of varying age categories

• Heterogeneity within the studied groups

• Small or big sample sizes, randomized or not

• No consistency in validation

• Use different instrument for similar measure.

Instruments are validated, or not, in the population

of elderly

• Use self-reported questionnairs, sometimes sent by

mail or answered by telephone survey

• Screening with the SOGS or SOGS-R

• Some SOGS items are inapropriate for elderly

• SOGS-R fail to reveal a clear and consistant

distinction between problem gambling an

pathological gambling (Wiebe & al., 2005)


Conclusion

• The elderly are an important and

specific group to study with regard

to gambling behavior and excessive

gambling

• Necessity to develop

• more homogeneous studies

• new specific screening instruments

• research in the field of non-conscious

(implicit) cognition

• research about basic psychological

processes (impulsivity, external vs

internal encoding style)


Thank you

for your attention

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