High-stakes gambling: seniors may be the losers.

The U.S. government has almost always allowed some limited legal gambling. In recent years, gambling has proliferated and is legal in some form, including racetracks, casinos, lotteries, bingo, and cards, in almost every state. Observational data and anecdotal reports have created concern that gambling rates, and especially rates of problem gambling, are increasing, especially among the elderly. Most research on gambling among the elderly is conducted in casinos, simply because so many elders visit them, and they are now the largest gambling venues in the nation. Risk factors for problem gambling include alcohol or substance abuse, low socioeconomic neighborhood residence, access to gambling opportunities, family and friend acceptance of gambling, and participation in a greater number of gambling types. More than 80% of elders gamble as a social activity and gamble responsibly. However, some elders are problem or pathological gamblers, and are vulnerable to financial instability. Currently, people older than 65 years of age comprise 39% to 45% of casinos' traffic, partly because casinos target this market heavily. Once it becomes clear that gambling is a problem, individuals can receive counseling and interventions such as a 12-step program and cognitive-behavioral therapy. Pharmaceutical interventions are fairly new, but promising.