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Purpose: Pathological gambling is an increasing public blers, but differences in psychosocial problems across the
health concern, but very little is known about this disorder age groups may suggest the need for interventions tai-
in older adults. This study evaluated gambling and psycho- lored to particular issues encountered by older pathologi-
social problems across age groups in treatment-seeking cal gamblers. Specifically, treatments focusing on later
gamblers. Design and Methods: At intake to gambling life development of problems may be indicated for older
treatment programs, 343 pathological gamblers completed female gamblers.
the Addiction Severity Index (ASI) and gambling question-
Key Words: Pathological gambling, Older adults,
naires. Participants were categorized by age into young Gender, Treatment
adults (ages 18–35 years; n 97), middle-aged adults
(ages 36–55 years, n 197), and older adults (aged
older than 55 years, n 49). Differences in demograph-
Pathological gambling affects about 1.6% of the
ics, gambling variables, and ASI composite scores were
adult population (Shaffer, Hall, & Vander Bilt, 1999).
compared across the groups. Results: The middle- and The personal and social effects of this disorder in-
older age gamblers were more likely to be female (45%– clude significant financial losses, family problems, le-
55%) than were the younger gamblers (23%), but the gal and employment difficulties, and psychological
groups were similar with respect to most other demo- distress, including suicide (Petry & Armentano, 1999).
graphic variables. When controlled for gender, older However, relatively little is known about the ante-
age was associated with increased employment prob- cedents or correlates of pathological gambling in
lems, but fewer social, legal, and substance-abuse diffi- older adults.
culties. Compared with middle-aged gamblers, older Older age is often associated with lower rates of
gamblers wagered on fewer days. Age Gender effects pathological gambling (National Research Council,
emerged in onset of gambling problems and amount 1999; Shaffer et al., 1999). In general population
spent gambling. Older women did not begin gambling surveys, prevalence rates of pathological gambling in
regularly until an average age of 55 years, whereas older adults are quite low. For example, in the Na-
older male gamblers generally reported a lifelong his-
tional Opinion Research Center’s (NORC; 1999)
telephone survey, only 0.4% of individuals aged
tory of gambling. The older female gamblers also wa-
older than 65 years met diagnostic criteria for patho-
gered the greatest amounts in the month prior to treat- logical gambling.
ment entry. Implications: These data suggest that older Although these data may suggest that gambling is
adults compose a minority of treatment-seeking gam- not a significant public health concern among older
adults, this conclusion must be drawn with caution.
Many studies do not break out prevalence rates by
This research was supported in part by the Patrick and Catherine Wel- age groups, and usually less than 20% of individuals
don Donaghue Medical Research Foundation Investigator Program and in telephone surveys are in the oldest cohorts. In the
NIH Grants R01-MH60417, R01-MH60417-Supp, R01-DA13444, R29- NORC (1999) study, for example, less than 400 re-
DA12056, P50-AA03510, P50-DA09241, and the Claude Pepper Older
Americans Independence Center at University of Connecticut Health Cen- spondents were 65 years or older. This sample size
ter (Grant P60-AG13631). may not be large enough to derive accurate estimates
JoAnne Boccuzzi, Jaime Kelley, and Cheryl Molina assisted in data col-
lection and management, and the staff at the Compulsive Gambling of prevalence rates for a disorder that occurs at a rel-
Treatment Program, Bettor Choice Programs, and the Connecticut Council atively low frequency.
on Problem Gambling are thanked for their participation in this project. Only one known published report focused exclu-
Dr. Richard Fortinsky provided helpful suggestions on the manuscript.
Address correspondence to Nancy M. Petry, PhD, Department of Psy- sively on gambling in older adults. McNeilly and
chiatry, University of Connecticut Health Center, 263 Farmington Burke (2000) surveyed a nonrandom sample of 315
Avenue, Farmington, CT 06030-3944. E-mail: petry@psychiatry.uchc.edu
1
Department of Psychiatry, University of Connecticut Health Center, older adults in Nebraska. Ninety-one participants
Farmington. were recruited from gaming facilities (commercial
92 The Gerontologist
and charitable bingo facilities or in a shuttle bus day- all withdrawals were related to dissatisfaction with
trip to a casino), and 224 were recruited from senior random assignment procedures in the treatment
and retirement centers of American Association of study. Most participants learned about the treatment
Retired Persons chapter members. Among the partic- programs through one or more of the following
ipants surveyed at gaming venues, 11% were classi- sources: media advertisements, professional social
fied as pathological gamblers. About 3% of those service referrals, the Connecticut Compulsive Gam-
surveyed from other community events were patho- bling Helpline, or word-of-mouth referrals. No dif-
logical gamblers. This study, albeit of a sample of ferences in demographic characteristics were noted
convenience, suggests a clinically significant rate of among participants receiving treatment at the differ-
disordered gambling in older adults, especially among ent programs, so data were pooled for analyses. The
those with recent participation in gambling activities. study was approved by the University of Connecticut
The expansion of legalized gambling opportunities Health Center Institutional Review Board.
in the past 15 years may be associated with a rise in
94 The Gerontologist
Table 2. Gambling Variables Across Age Groups and Genders
ASI-gambling*
Men 0.64 (0.23) 0.67 (0.25) 0.56 (0.34)
Women 0.59 (0.26) 0.71 (0.21) 0.68 (0.20)
SOGS score†
Men 12.5 (3.5) 12.6 (4.0) 13.7 (4.7)
Women 11.7 (4.3) 12.2 (3.3) 10.0 (3.9)
Age first gambled***,‡
Men 17.0 (5.1) 17.5 (8.5) 21.2 (12.9)
Women 21.3 (6.5) 30.4 (10.8) 41.7 (18.7)
Age started gambling regularly*** ,‡
Men 21.0 (4.8) 27.5 (11.7) 33.2 (18.7)
In terms of lifetime gambling problems, a signifi- Days of gambling in the past month differed
cant effect of age group did not emerge on SOGS among the three age groups, F(2,336) 4.07, p
scores, but gender, F(1,330) 10.02, p .001, and .05, with the middle age group gambling most fre-
Age Gender effects, F(2,330) 3.65, p .05, quently. Gender and the interaction between gender
were significant. Women had lower scores than men and age were not related to days of gambling.
did, and this effect was most pronounced in the old- Amount wagered in the past month did not differ be-
est women, who had the lowest SOGS scores, indica- tween genders. However, the Age Gender interac-
tive of fewer lifetime gambling problems. tion effect was significant, F(2,336) 4.60, p .05,
Older gamblers were likely to begin gambling later with older women wagering the largest amounts.
in life, F(2,329) 21.29, p .001, as were women, Amount gambled as a percentage of monthly income
F(1,329) 86.63, p .001. An Age Gender effect also varied across the age groups, F(2,323) 3.00,
was noted, F(2,329) 9.63, p .001, with older p .05, as well as between genders, F(1,323)
women not initiating gambling until an average age 4.57, p .05. Women gambled large proportions of
of 42 years. This pattern was similar with respect to their monthly incomes prior to entering treatment,
the age at which participants began gambling regu- and this effect was especially pronounced in older
larly, and the effects of age, gender, and Age Gen- women, who gambled in excess of 200% of their in-
der were all significant, with F(2,333) 58.85, comes. No significant differences in gambling debt or
F(1,333) 84.15, and F(2,333) 9.78, ps .001. previous gambling treatment were noted across
The total number of years of gambling problems also groups.
differed among the three age groups, F(2,333) Employment, social, and legal variables are shown
6.95, p .01, as well as between genders, F(1,333) in Table 3. ASI employment composite scores dif-
29.90, p .01. The Age Gender interaction was fered among the three age groups, F(2,322) 8.70,
significant as well, F(2,333) 4.59, p .01. Before p .05, with the middle age group having the least
entering treatment, men (especially older men) expe- severe problems. Average responses to some of the
rienced a longer duration of gambling problems than items that are included in the employment section are
women did. shown in Table 3, and, as a reference point, employ-
ASI employment*
Men 0.24 (0.23) 0.19 (0.22) 0.30 (0.18)
Women 0.33 (0.24) 0.19 (0.18) 0.31 (0.18)
Employed full time (%)***
Men 78.7 81.8 40.9
Women 45.5 71.3 33.3
Monthly income (median and IQ range)*
Men $1,425 (1,796) $2,100 (2,560) $720 (2,200)
Women $450 (1,200) $1,482 (1,200) $960 (1,900)
ASI social**
Men 0.36 (0.22) 0.33 (0.24) 0.30 (0.22)
ment composite scores in drug-abusing patients usu- reported engaging in illicit activities than did the
ally range from 0.6 to 0.8, substantially higher than older participants, 2(2, N 343) 15.91, p .001.
scores in these pathological gamblers. Not surpris- Drug and alcohol variables are shown in Table 4.
ingly, fewer older participants were employed full Controlling for gender, ASI composite scores were
time compared with younger participants, 2(2, N significantly different across the three age groups,
343) 30.48, p .001, but only 9.1% of the men F(2,332) 5.18 and 3.89, ps .05, for alcohol and
and 18.5% of the women in the oldest cohort were drugs, respectively. The youngest age group had the
retired (data not shown). Past-month income differed highest ASI scores, whereas the two older age groups
across the age groups, F(2,322) 5.18, p .01, did not differ from one another. Younger gamblers
with the middle age group having the highest monthly were more likely to smoke cigarettes than older gam-
income. blers were, 2(2, N 343) 10.25, p .01. The
Scores on the ASI social problem index differed majority of participants in the younger and middle age
across the age groups, with the oldest age group groups had smoked marijuana in their lifetimes, al-
showing the fewest problems, F(2,299) 3.89, p though marijuana use was less prevalent in the older
.05. Older adults were more likely to be satisfied age group, 2(2, N 343) 37.35, p .001. A sim-
with their marital and living situation than were ilar age effect was noted with respect to cocaine use,
younger adults, 2(2, N 343) 6.05, p .05. 2(2, N 343) 10.87, p .01. No age-related dif-
Controlling for gender, ASI legal scores also dif- ferences emerged in terms of percentages of the par-
fered across the age groups, F(2,328) 3.62, p ticipants who had ever been treated for a substance-
.05, with most severe legal problems in the youngest use disorder. Relative to the youngest age group, the
age group. No age effects emerged with respect to older participants were also less likely to have used
the percentages ever incarcerated in their lifetimes. illicit drugs in the month prior to entering treatment
However, the youngest age group was more likely to for gambling, 2(2, N 343) 24.45, p .001.
be on probation or parole, 2(2, N 343) 12.02,
p .01. About 10% of the sample was awaiting le- Discussion
gal charges, trial, or sentencing, and these percent-
ages did not differ among the age groups. In the past These data suggest that older treatment-seeking
month, significantly more of the younger participants pathological gamblers differ from younger and mid-
96 The Gerontologist
Table 4. Drug and Alcohol Variables Across Age Groups bling until casinos became legalized on Native Amer-
and Genders ican reservations in Connecticut in 1992. Most of the
women reported casino gambling, and slot machines
Middle- in particular, to be their preferred form of gambling.
Young Aged Older In contrast, the older men generally reported a
Variable Adults Adults Adults
lifelong history of gambling. Over 75% began gam-
bling in their teenage years, and 77% began regular
ASI alcohol*
Men 0.13 (0.16) 0.08 (0.13) 0.04 (0.08) gambling prior to the age of 30 years. Because most
Women 0.09 (0.19) 0.05 (0.12) 0.04 (0.09) states had no forms of legalized gambling in the
ASI drug* 1950s to 1960s when they began gambling, these
Men 0.03 (0.08) 0.00 (0.01) 0.00 (0.02) men probably were participating in illicit forms of
Women 0.02 (0.08) 0.01 (0.03) 0.00 (0.01) gambling during their youth. The high rate of incar-
Current cigarette
ceration (32%) in these older male pathological gam-
smokers (%)**
98 The Gerontologist
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