A free ride? An analysis of the association of casino bus tours and problem gambling among older adults

Gambling in Older Adulthood: Longitudinal Associations Between Stressful Life Events, Individual, and Social Factors

Older adults are receiving increased attention in gambling research, in part because gambling and related problems appear to be increasing in this population. To date, little or no research has examined the complexities of gambling and later-life circumstances, including life events, and individual and social factors. This study utilized longitudinal data (5 waves) from older adults (60 + ; N = 670) in the Quinte Longitudinal Study (Williams et al., in: The Quinte longitudinal study of gambling and problem gambling 2006-2011, Bay of Quinte region, Ontario, 2014). Longitudinal multilevel models examined between- and within-person effects of stressful life events on gambling frequency and Problem Gambling Severity Index (PGSI) scores, and the possible moderating role of individual (age, gender, mental health, physical health) and social variables (marital status, social support) on this relationship. Results of the final model showed significant effects (p < .01) for linear time (PGSI scores declined across waves; β = - .06); gender (women's mean PGSI greater than men's; γ = .26); social support (less support associated with greater PGSI; γ = .05); and an interaction between age and stressful life events (effect of stressful events on PGSI is lesser with greater age; γ = - .02). Simple slopes (at mean age of 66 at wave 1, and ± 1SD) showed that at 61 (γ = .35) and 66 years (γ = .23), mean PGSI scores were greater with each additional stressful life event; there was no significant effect for stressful events at age 71. These findings suggest women, those with less social support, and greater stressful life events may be at greater risk of problem gambling, while greater age weakens the effect of stressful events and problem gambling.

A scoping review of the individual, socio-cultural, environmental and commercial determinants of gambling for older adults: implications for public health research and harm prevention

Gambling is a global public health issue that can cause harm to individuals, families, and communities. Older adults are vulnerable to gambling harm due to life-stage experiences. This study aimed to examine current research relating to individual, socio-cultural, environmental, and commercial determinants of gambling among older adults. A scoping review was conducted (PubMed, PsycInfo, SocIndex, CINAHL Complete, Web of Science, Social Science and Sociology databases available in ProQuest, Google Scholar, citation searching), with peer reviewed studies included that were published between 1 December 1999 and 28 September 2022. Included studies were published in English in peer-reviewed journals that examined the determinants of gambling in adults aged 55 and over. Records were excluded if they were experimental studies, prevalence studies or had a population wider than the required age group. Methodological quality was assessed using JBI critical appraisal tools. Data was extracted using a determinants of health framework and common themes were identified. Forty-four were included. Most literature examined individual and socio-cultural determinants including reasons for gambling, risk management strategies, and social motivations for gambling. Few studies investigated environmental or commercial determinants, and those that did focused on accessibility of venues or promotions as pathways to gambling. Further research is needed to understand the impact of gambling environments and industry, and effective public health responses for older adults.

Understanding gambling in the United Kingdom: A qualitative study on the experiences of gamblers' families

This study focuses on understanding the experiences of family members of problem gamblers in the United Kingdom and the gambling consequences in their lives. Family members of problem gamblers, even though they suffer from gambling consequences, the impacts of gambling are under-researched. Qualitative research through in-depth interviews was employed. Thematic analysis was used to gain a deeper insight into gambling. Nine female participants were interviewed based on a semi-structured questionnaire. The results of this study indicated that close family members of problem gamblers had suffered not only financial devastation but also harsh psychological and mental health damages. Furthermore, family members suffer from gamblers' abusive and violent behaviors. Addiction was a key factor of gamblers' habit; fear, anxiety, and depression were some of the health issues derived from gambling. Overall, gambling addiction leads to further addiction, crime, and severe, family-relation sufferings. The study results suggest that the London Gambling Commission and regulating authority should change gambling policy, reduce gambling points, and limit gambling slot machines in food markets and community areas. More support is needed for family members affected by gamblers' addictive gambling behaviors.

A critical qualitative inquiry of the social practices of older adult gamblers: implications for public health risk prevention

Older adults' participation in gambling is increasing internationally. Due to their lifestage, older adults may be vulnerable to gambling-related harm. When investigating older adults' gambling, researchers have mostly focused on the individual characteristics of ‘problem gamblers’. Less is known about the socio-cultural, environmental and commercial factors that may influence older adults' gambling behaviours. Utilising Social Practice Theory, this critical qualitative inquiry of N = 40 Australian older adults (aged 55 and over) explored how social practices influenced gambling participation. Using a Constructivist Grounded Theory approach, data were interpreted using a reflexive thematic analysis. Theme 1 identified how gambling practices fulfilled older adults' social needs. Gambling was embedded in social activities and created a sense of belonging. Theme 2 highlighted how gambling became an everyday part of some participants' lives, with a range of routines constructed around gambling. While social factors influenced routinised gambling behaviours, the accessibility of gambling products in everyday settings contributed to engagement with gambling. This study demonstrates that a range of social, environmental and commercial factors may influence and routinise the gambling practices of older adults. Interventions aimed at preventing and reducing routine gambling participation among older adults should acknowledge the interplay between agency and social structure. Public health responses should aim to disrupt routine behaviours associated with gambling for older adults.

Examination of the Problem Gambling Severity Index for Use with Older Adults: A Rasch Model Approach

Research and prevalence studies commonly use the nine-item Problem Gambling Severity Index (PGSI; Ferris and Wynne in The Canadian Problem Gambling Index, 2001) to measure problem gambling severity in older adults. However, the appropriateness of the PGSI for use with older adults must be evaluated to ensure accurate interpretation of scores. This study evaluated the PGSI with older adults that gamble using a Rasch model approach, which has not yet been examined in the literature. Data from the Quinte Longitudinal Study (Wiiliams et al. in The Quinte Longitudinal Study of Gambling and Problem Gambling 2006-2011, Bay of Quinte region, Ontario [Canada] (V28), 2014) were utilized, accessed through the Gambling Research Exchange of Ontario (GREO). Using WINSTEPS.V5, a Rasch rating scale model was applied to an older adult sample from Ontario, Canada (n = 571, M_age = 66, range = 60-80 +) to assess: (1) the dimensionality and fit between individual PGSI items and the underlying latent construct of problem gambling; (2) utility of items and response options; and (3) potential differential item functioning (DIF) between genders. Using a larger sample (N = 3206, M_age = 45, range = 18-80 +), DIF was examined across three age subgroups. Results supported unidimensionality of the PGSI and item polarity (r_pm range = 0.42-0.85). Infit and outfit statistics showed mixed model misfit for three items. The use of three response options were deemed productive for measurement, but almost always was not frequently endorsed. Model-person separation (1.00) and reliability (0.50) were poor, and model-item separation (6.12) and reliability (0.97) were excellent. There was no significant DIF between older adults by gender. Three items showed significant DIF between older and younger adults. Possible modifications to improve the PGSI for use with older adults are discussed.

Reviewing the Consequences of Electronic Gaming Machine Misuse in Australian Older Adults: Implications for Addiction Nurses

ABSTRACT

This review explores contemporary literature exploring electronic gaming machine (EGM) use in the Australian context. EGMs, colloquially known in Australia as pokies (poker machines), lead statistics on gambling losses in Australia and are a substantially different form of gambling when compared with other means, such as sports or casino wagering. This article focuses on Australian literature on EGMs, with comparisons made with international trends. Searches of the Scopus, CINAHL, and Medline electronic journal databases were performed to find literature examining problem gambling through EGM use in older adults. The results of the search found that little literature exists regarding problematic EGM use in older adults; however of the studies that do exist, problem EGM use in the older adult cohort is frequently related to mental ill health as well as alcohol, tobacco, and other substance use. Addiction nurses are in a unique position to assess and detect problematic EGM gambling in older adults; however, few screening tools are used in clinical practice. Given the ease of access and increasing sophistication of EGMs, it is foreseeable that problematic EGM use will be an issue addiction nurses encounter in their future practice and one they should be aware of.

Associations Between Gambling and Cognitive Function among U.S. Chinese Older Adults

This study aims to examine the associations between gambling participation, problem gambling, and cognition. Data were derived from the PINE study. Gambling participation was measured by Modified South Oaks Gambling Screen. Problem gambling was assessed with Problem Gambling Severity Index. Cognition was measured by East Boston Memory Test, Digit Span Backward, Symbol Digit Modalities Test, and Mini-Mental State Examination. Of all participants, 41.940% were male. Higher gambling participation was significantly associated with higher global cognition (b = .008, SE = .003, p < .05), executive function (b = .118, SE = .049, p < .05), and episodic memory (b = .009, SE = .004, p < .05). Higher problem gambling was significantly related to lower Mini-Mental State Examination (b = -.105, SE = .031, p < .001). Guiding older adults' gambling behaviors and intervening in problem gambling timely might be crucial for their cognitive function.

Psychosocial risk factors in disordered gambling: A descriptive systematic overview of vulnerable populations

BACKGROUND

Gambling is a behaviour engaged in by millions of people worldwide; for some, gambling can become a severely maladaptive behaviour, and previous research has identified a wide range of psychosocial risk factors that can be considered important for the development and maintenance of disordered gambling. Although risk factors have been identified, the homogeneity of risk factors across specific groups thought to be vulnerable to disordered gambling is to date, unexplored.

METHODS

To address this, the current review sought to conduct a systematic overview of literature relating to seven vulnerable groups: young people and adolescents, older adults, women, veterans, indigenous peoples, prisoners, and low socio-economic/income groups.

RESULTS

Multiple risk factors associated with disordered gambling were identified; some appeared consistently across most groups, including being male, co-morbid mental and physical health conditions, substance use disorders, accessibility and availability of gambling, form and mode of gambling, and experience of trauma. Further risk factors were identified that were specific to each vulnerable group.

CONCLUSION

Within the general population, certain groups are more vulnerable to disordered gambling. Although some risk factors are consistent across groups, some risk factors appear to be group specific. It is clear that there is no homogenous pathway in to disordered gambling, and that social, developmental, environmental and demographic characteristics can all interact to influence an individual's relationship with gambling.

"It's Not Officially Gambling": Gambling Perceptions and Behaviors Among Older Chinese Immigrants

Personal and media accounts have suggested that Chinese communities engage in high rates of gambling, which is reflected in the fact that casinos are specifically targeting Chinese communities through advertisements and promotions. However, not much is actually known about older Chinese immigrants' experiences and perceptions of gambling in the U.S. This study seeks to explore how older Chinese immigrants define and describe gambling and their own gambling behaviors. Thematic analysis was used to identify major themes across in-depth interviews of 25 older Chinese immigrants living in New York City. Our analysis identified three avenues in defining gambling. First, they differentiated "gambling" from "playing." Second, they equated "gambling" with "problem gambling." Last, they associated "gambling" with major losses. In describing their own motivations for gambling and playing, participants indicated that there were many positive reasons for playing. The analyses revealed four themes under which participants described their motivations: gambling as a coping strategy; gambling as a form of socialization; gambling to improve health; and gambling to prove their luck or skill. Identifying older Chinese immigrants' perceptions and motivations around gambling can better equip us to address their needs.

Moderate to severe gambling problems and traumatic brain injury: A population-based study

Traumatic brain injury (TBI) is a common injury characterized by a change in brain function after an external blow to the head and is associated with substance abuse, psychological distress, risk-taking, and impulsivity. Convenience and clinical samples have also linked TBI to problem gambling, but have not ruled out confounding variables such as hazardous drinking and psychological distress. This study examines the relationship between TBI and moderate to severe problem gambling in a general population probability sample controlling for hazardous drinking and psychological distress. The data were obtained from a 2015-2016 cross-sectional general population telephone survey of adults ages 18+from Ontario, Canada (N = 3809). Logistic regression was used to estimate the association as adjusted odds ratios (AOR). Moderate to severe problem gambling was independently associated with a history of TBI after adjusting for potential confounders (AOR: 2.80), and had a statistically significant relationship with psychological distress (AOR = 2.74), hazardous drinking (AOR = 2.69), and lower educational levels (AOR = 0.37). This study provides further data to suggest a link between TBI and moderate to severe problem gambling; however, more research is needed to determine if there is a causal relationship or the potential implications for prevention and treatment.

Determinants of Gambling Disorders in Elderly People-A Systematic Review

Background: Despite the growth in the number of studies on gambling disorders (GDs) and the potentially severe harm it may cause, problem gambling in older adults is rarely apparent in literature. Driven by the need to overcome this limitation, a broad systematic review is essential to cover the studies that have already assessed the determinants of GD in the elderly. Objectives: The aim of this systematic review is to understand the determinants related to GDs in elderly people. Methods: A total of 51 studies met the inclusion criteria, and data were synthesized. Results: Three major types of determinants were identified in this review: individual, socio-financial and environmental. Conclusions: This review explored the determinants influencing GDs in older people. The findings are relevant to academics, policymakers, patients, and practitioners interested in the identification and prevention of GD in older people.

A free ride? An analysis of the association of casino bus tours and problem gambling among older adults

BACKGROUND AND AIMS

Little research has examined the relationship between incentives used by gambling venues to attract customers and the experience of gambling-related harm. Organized and subsidized bus tours are a common example of such incentives. The aim of this study was to examine whether bus-tour patronage was associated with increased odds of problem gambling among older adults. This study also compared rates of bus-tour use by socio-demographic characteristics and gambling behaviours.

DESIGN

Pearson's χ² tests and Mann-Whitney U-tests were applied for bivariate analyses. Multivariate generalized mixed-effects regression modelling was used to examine the relationship between bus-tour patronage and problem gambling while controlling for possible confounding factors.

SETTING

Seven gambling venues located in Central and Southwestern Ontario, Canada.

PARTICIPANTS

A total of 1978 gambling venue patrons over the age of 55 years.

MEASUREMENTS

Problem gambling as indicated by the Problem Gambling Severity Index, bus-tour patronage in the 12 months prior to the survey, spending per gambling visit and past-month slot machine participation.

FINDINGS

Regression analyses showed that bus-tour patronage was associated with higher odds of problem gambling [odds ratio (OR) = 1.71, confidence interval (CI) = 1.06, 2.76] after controlling for several demographic characteristics, type of gambling and gambling expenditures. Bivariate analyses showed past-year bus-tour patronage was associated with more frequent slot machine play (χ² = 48.16, P < 0.001), more past-year gambling venue visits (P < 0.001) and lower spending on gambling per casino visit (P < 0.001). Compared with non-patrons, bus tour patrons were more likely to be female (χ² = 21.92, P < 0.001), born outside Canada (χ² = 113.18, P < 0.001), above the age of 75 (χ² = 24.02, P < 0.001) and retired (χ² = 16.60, P < 0.001).

CONCLUSIONS

When adjusting for potential confounders among older adults, using bus tours to access Canadian gambling venues is associated with increased risk of problem gambling. Bus-tour patrons are more likely to be female, born outside Canada and above the age of 75 years.