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Gambling Among Older, Primary-Care Patients

An Important Public Health Concern

Received May 27, 2003; revised October 15, 2003; March 5, 2004; accepted March 24, 2004. From the Depts. of Psychiatry (SL) and Health Evaluation Sciences (SL,AMD), Pennsylvania State College of Medicine, Hershey, PA, the Center for Mental Health Care Policy and Services Research, Dept. of Psychiatry (CZ), and Section on Geriatric Psychiatry (KK,DWO), Univ. of Pennsylvania, Philadelphia, PA, the Dept. of Psychiatry, Univ. of Pennsylvania, Philadelphia, PA (KK,DWO), the Philadelphia VA Medical Center, VISN 4 MIREECC (DWO), and the Center for the Study of Addictions, Dept. of Psychiatry, Univ. of Pennsylvania, Philadelphia, PA (DWO). Send correspondence and reprint requests to David Oslin, M.D., Univ. of Pennsylvania, 3600 Chestnut St., Room 790, Philadelphia, PA 19104. e-mail: Oslin{at}mail.med.upenn.edu
© 2005 American Association for Geriatric Psychiatry

Objectives: Authors assessed the prevalence rate of gambling in a sample of elderly patients (over age 65) and evaluated the sociodemographic characteristics, health, cognitive status, and psychiatric comorbidities of elderly gamblers. Methods: This study is a cross-sectional survey of gambling habits. A random sample of older adults with a scheduled primary-care clinic appointment was selected and screened with the General Health Questionnaire and questions about suicidality and alcohol use. Also, participants were asked about their gambling habits. Results: Of 843 screened patients completing the gambling questionnaire, 69.6% reported that they had participated in at least one gambling activity in the last year. At-risk gamblers were defined as those who reported having bet more than $100 on a single bet and/or having bet more than they could afford to lose in the last year. Of those responding, 10.9% were identified as at-risk gamblers. The strongest predictors of at-risk gambling behavior were being a binge drinker, presence of current posttraumatic stress disorder symptoms, minority race/ethnicity, and being a VA clinic patient. Subjects with mild-to-moderate cognitive impairment were just as likely as those without impairment to gamble and to report at-risk gambling behavior. At-risk gambling behavior was not significantly associated with gender, current or past depressive symptoms, or cigarette smoking. Conclusions: These data raise a significant public health concern that gambling behaviors are prevalent in older adults. Additional research is needed to further define the determinants of gambling behavior in older adults and evaluate the social, health, and economic costs and benefits of gambling by older adults, especially among those groups determined to be at risk.

Key Words: Gambling Addiction • Primary Care

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