Unexpected online gambling disorder in late-life: a case report

Abstract

Background: The lifetime prevalence of problem or Gambling disorder (GD) in the elderly (i.e., those over 60 years old) is reported to range from 0.01 to 10.9%. Research has identified several specific risk factors and vulnerabilities in the elderly. Since the late 1990s, an increase in online GD has been observed in the youth population, whereas casinos, slot machines, and bingo seem to be the activities of choice among the elderly. Interestingly, online GD has not been described in the elderly to date.Case Description: We report an 83-year-old man who started online casino gambling from the age of 80 years, leading to debts that exceeded €30,000. He underwent a full clinical and neuropsychological assessment, without any evidence of cognitive impairment or any associated neurodegenerative disease. However, he had risk factors for GD, including adjustment disorder, stressful life events, previous offline casino GD when 50 years old, and dysfunctional personality traits. The change to online GD may have been due to his isolation, movement difficulties, and his high level of education, which facilitated his access to the Internet. Care management focused on individual cognitive-behavioral therapy.Conclusion: The prevalence of online GD may be underestimated among the elderly, and may increase among isolated old people with movement difficulties and ready access to the Internet. However, late-life GD should be considered a diagnosis of elimination, requiring a full medical, psychiatric (including suicide risk), and cognitive assessment. Specific therapeutic approaches need to be proposed and developed.

Suicidal ideation and history of suicide attempts in treatment-seeking patients with gambling disorder: The role of emotion dysregulation and high trait impulsivity

“…(2014) explored age as a moderator of gambling pathology and observed that the older the patient, the higher the comorbid health problems and the emotional distress they presented (measured by means of the SCL-90-R). Bearing these findings in mind, gambling behaviors in older adults could be associated with a need to ameliorate negative feelings and to cope with stressful situations related to older age (Sauvaget et al., 2015; Subramaniam et al., 2015).…”

Attitudes towards gambling, gambling participation, and gambling-related harm: cross-sectional Finnish population studies in 2011 and 2015

“…The literature on older individuals’ online gambling as well as on gender differences in online gambling is scarce [ 60 ]. In general, we know that females tend to favour non-skill games such as slot machines and bingo [ 61 ].…”

Gender comparison of online and land-based gamblers from a nationally representative sample: Does gambling online pose elevated risk?

“…It is also known that older adults favor casinos, slot machines and bingo as gambling activities (Tse, Hong, Wang, & Cunningham-Williams, 2012), with distinct motivations to gamble (entertainment and leisure more than money and rewards) (Martin, Lichtenberg, & Templin, 2011). Overall, online problem gambling studies conducted among older adults remain scarce (Sauvaget et al, 2015).…”