Gambling refers to any operation offered to the public, under any name whatsoever, in order to raise the hope of a gain which is due, even partially, to chance, and for which a financial sacrifice is required from the participants [1]. Gambling is therefore an activity that relies on chance and in which someone risks money in order to win. This risky activity is increasingly part of the daily lives of people from many cultures ^[2][3][4][2,3,4] and is of concern to the World Health Organization itself [5]. From North America to Australia, Europe, Africa, and Asia, more than one in two individuals on average report having gambled in the past year ^{[6][7][8][9][10]}[6,7,8,9,10]. Among older adults from different countries, those with a non-Caucasian cultural identity range from 26.6 to 56.2 percent to gamble [11], with participation across all cultures ranging up to 85.6 percent [12]. In France, 49.3% of 55–64 year olds and 37.6% of 65–75 year olds gambled in 2019 [7]. Older adults have positive attitudes towards gambling, which is seen as an ordinary and safe form of entertainment ^[11][13][11,13]. While 79.5% of people over 60 say they gamble for entertainment, 62.7% also say they gamble to win money [14]. Additionally, it is when gambling is perceived as a reward in itself that gambling is risky [15].

How can the gambling attractiveness among older adults be explained? The occupational, emotional, financial, and health-related changes experienced by this population mean that they have a lot of free time available and a different relationship with money, leisure, and the future, making older adults a prime clientele for gambling promoters [15]. In a Silver Economy logic [16], older adults are the target of many marketing campaigns ^[17][18][17,18], which present gambling offers as the perfect answer to seniors’ needs (organized service road to casinos, first bet offered, and promise of socialization), as well as a means to fight isolation [19]. Isolation is the common theme in the three trajectories that can lead older adults from recreational to gambling disorder: a habit pathway associated with gambling habituation, a dormant pathway marked by pre-existing excessive behaviors or impulsivity, and a grief pathway associated with unresolved losses [20]. Increased availability and exposure to gambling products and establishments can send older adults down the habit pathway. Since increased exposure leads to gambling disorder, rates of gambling disorder among older adults are likely to increase [21]. Numerous studies have shown an increase in participation rates and rates of gambling-related disorders among older adults (for a review, [22]). These increases are expected to become even more pronounced in the coming years simply because of the population aging [23].

2. Older Adult Gamblers: Age, Characteristics, and Motivations to Gamble

2.1. Older Adult Gamblers’ Age

Although the World Health Organization set the age of entry into old age at between 60 and 65, this institution recognizes that old age must be defined by new roles and various factors other than biological age ^[24][26]. Even though the term “senior”, which appeared in the early 1990s, refers to those over 55 years of age or even over 45 years of age in the workplace ^[25][27], some people have proposed the probability of surviving 10 years as an indicator of entry into old age, thus advancing the age of old age in line with the increase in demographic aging ^[26][28]. The age of old age is therefore a matter of debate. There is also no consensus in the gambling literature, with the lower bound being, depending on the study, 50 years (e.g., ^[27][28][29,30]), 55 years (e.g., ^{[2][12][17][29][30][31][32][33][34][35]}[2,12,17,31,32,33,34,35,36,37]), 56 years (e.g., ^[36][38]), 60 years (e.g., ^[14][37][38][14,39,40]), 65 years (e.g., ^[39][40][41][41,42,43]), or sometimes 70 years (e.g., ^[42][44]). The chosen limit is only rarely justified. For Asian studies, the reason is that retirement is at age 55. Granero et al. ^[28][30] justified the lower limit of 50 years because of the large variations in the literature. Pilver et al. ^[33][35] defined the limit of 55 for comparability with previous work. In Connecticut, Petry ^[43][45] found that older female gamblers began regular gambling at age 55, whereas regular gambling among older male gamblers began before age 30. The large prevalence survey on substance use and gambling among seniors ^[44][46] in New Brunswick, Canada, set the cut-off at 55. Lastly, age 55 was identified as a reasonable threshold for the onset of age-related impairment in decision-making ^[45][47].

2.2. Older Adult Gamblers’ Characteristics

The question of the profile of the older gambler does not lead to any definitive typical conclusion. There are variations by gender and socioeconomic level in the general population, but there is no clear pattern among older adults ^[46][24]. Some studies suggest that the prevalence of gambling disorder among older adults is higher among men than women ^[47][48][48,49], but others indicate that it is similar or even higher among women ^{[49][50][51][52]}[50,51,52,53]. At the socio-economic level, while education ^[48][49] and income ^[53][54] have been identified by some studies as risk factors, others have found no link ^[47][48]. Regarding types of gambling, there are games of pure chance, non-strategic, such as lotto or casino games, and games involving a degree of skill such as poker, sports betting, or horseracing ^[54][55]. Older adults prefer non-strategic games over strategic games ^[22][55][22,56], and the prevalence of gambling disorder is greater in casino games such as slot machines than in lotteries ^[52][53]. The theoretical model developed by Tira et al. [20] proposes three trajectories to gambling disorder. The habit pathway is characterized by repeated exposure to a gambling practice and conditions (“beginner’s luck” and big wins) that foster the entrenchment of erroneous beliefs (gambler’s fallacy, superstitions, and near-miss), which lead to an escalation of gambling activity. From a reason to start gambling, breaking the boredom becomes an excuse to gamble more. The dormant pathway relates to predispositions to compulsive behaviors. This pre-existing vulnerability, along with strong co-morbidities (tobacco and alcohol dependence) and low levels of self-control, leads to significant risk-taking for the sheer pleasure it provides. In contrast to this presumed biological or genetic predisposition of the dormant pathway, the occurrence of certain negative life events (essentially losses of various kinds and intensities) characterize the grief pathway. The emotional vulnerability induced by losses (of role, of loved ones, of income, or of physical abilities) gives rise to a need to gamble and to respond to the incentives linked to gambling, in order to escape negative emotions such as loneliness, despair, depression, or anger [20]. For example, older adults are likely to increase their gambling activity in the hopes of offsetting the loss of income ^[52][53]. Motivation to win money, combined with excitement seeking, predicts gambling disorder, especially among slot machine gamblers over 60 ^[52][53].

2.3. Older Adults’ Motivations for Gambling: Risk Factors or Not?

Of the studies that have examined gambling in aging people, the largest number have focused on motivations, with no universal consensus. While New Zealand older adults gamble to win money more frequently than younger gamblers ^[51][52], this is clearly not a pronounced motivating factor among British older adults [21]. For the latter population, gambling is an escape from the psychological (loneliness or grief) and physical (pain and decline) stress and discomfort associated with aging. The high accessibility and availability of gambling environments compared to other leisure activities make it a warm and feel-good activity [21]. The most common reasons reported by casino gamblers over 65 are to relax (68.1% of respondents), relieve boredom (30%), pass the time (42.7%), and go away for the day (43.7%) ^[56][57]. Of the five dimensions of motivation to gamble for older Americans (i.e., thrill of winning, escape, socialization, fun, and curiosity), the primary motivation is fun and pleasure ^[57][58]. From the perspective of self-determination theory ^[58][59][59,60], the main motivations of casino gamblers over the age of 60 refer to intrinsic motivations (i.e., the activity is a reward in itself), such as entertainment and pleasure. Two-thirds of respondents, however, expressed extrinsic motivations (i.e., the activity has an instrumental value or a utilitarian purpose), such as financial gain. More self-determined reasons for gambling (intrinsic motivations) are associated with greater participation in gambling, and less self-determined reasons (extrinsic motivations) are associated with less participation in gambling ^[60][61]. Beyond simple participation, for both older adults (M_age = 74.59) and younger adults (M_age = 22.61), the severity of gambling disorder is more associated with a tension-relief motivation than with money-making and thrill-seeking ^[51][52]. Motivational factors related to psychological and physical stress reduction [21] are similar, in the general population, to the coping motivations, via negative reinforcement, of the “behaviorally conditioned gambler” ^[61][62]. This subgroup of problem gamblers has no premorbid characteristics but has comorbidities that are consequences, not causes, of repeated problem gambling behaviors. These gamblers fluctuate between regular and problem gambling due to the effects of conditioning, increased vulnerability to erroneous cognitions, errors in judgment, and poor decision-making. With the least severe difficulties of all the problem gamblers, this subgroup is motivated to enter treatment and can successfully return to controlled levels of gambling after treatment ^[61][62]. Another motivation for older adults’ gambling is a desire to exercise one’s mind [12]. Gambling can, indeed, satisfy unmet psychological needs for not only emotional but also cognitive stimulation [21]. One of the reasons for the popularity of gambling among older adults is that it provides an opportunity for cognitive stimulation ^[62][63][64][63,64,65], which is thought to improve cognitive functioning and thus counteract the well-documented decline in cognitive performance associated with aging ^{[45][65][66][67][68]}[47,66,67,68,69]. Recreational gambling among older adults is associated with positive outcomes in terms of cognitive stimulation, socialization, health, and well-being ^[40][69][70][42,70,71]. In a leisure state, gambling increases activity, develops socialization processes, and stimulates cognitive functions, thus favoring better overall health ^[71][72]. Recreational gamblers over 65 report higher levels of “good to excellent” general health than non-gamblers ^[40][42]. Gamblers over the age of 60 develop cognitive and behavioral strategies to prevent them from falling into gambling disorder ^[70][71] and to keep their gambling under control. On the cognitive level, this involves keeping in mind the real dangers of gambling, being aware that the odds are stacked against one, and never considering oneself lucky; on the behavioral level, it involves regulating one’s practice through concrete actions such as only taking a predefined amount of money, not gambling alone, stopping and not reinvesting one’s winnings, and optimizing one’s gambling time by betting small sums. Thus, recreational gambling has a number of beneficial effects. On the other hand, problem-gambling behaviors have been associated with high levels of anxiety and loneliness ^[72][73][73,74]. Older adults may perceive gambling as a way to reduce negative mood states ^[41][43]. The need for protection and assertiveness contributes to sustained gambling ^[74][75]. When the primary motivation for gambling is to escape anxiety and loneliness, the likelihood of experiencing gambling-related harms is greater ^[23][35][41][23,37,43].