The moderating role of executive functioning in older adults' responses to a reminder of mortality

Cognitive decline, socioemotional change, or both? How the science of aging can inform future research on sacrificial moral dilemmas

Older adults comprise the fastest-growing population in the United States. By exercising their right to vote, guiding the value systems of future generations, and holding political office, they shape the moral context of society. It is therefore imperative that we understand older adults' capacity for moral decision-making. Although the vast majority of research on moral decision-making has either focused specifically on younger adults or has not considered age, recent work points to age-related differences in sacrificial moral decision-making, with cognitively healthy older adults making more deontological decisions relative to younger adults. Although only a small number of studies have to date examined age-related differences, there is a wealth of relevant literature on cognitive aging, as well as on sacrificial moral decision-making in younger adults, that point to possible mechanistic explanations for the observed age-related differences. The goal of this review is to situate these age-related differences in sacrificial moral decision-making in the context of these existing literatures in order to guide future, theory-informed, research in this area. We specifically highlight age-related decline in cognitive abilities purported to support utilitarian moral decision-making in younger adults, along with age-related changes to socioemotional information processing as potential mechanistic explanations for these age-related differences. The last section of this review discusses how age-related neural changes may contribute to both cognitive decline and motivational shifts, highlighting the importance for future research to understand brain-behavior relationships on the topic of sacrificial moral decision-making and aging.

Age Differences in the Subcomponents of Executive Functioning

OBJECTIVES

Across the life span, deficits in executive functioning (EF) are associated with poor behavioral control and failure to achieve goals. Though EF is often discussed as one broad construct, a prominent model of EF suggests that it is composed of three subdomains: inhibition, set shifting, and updating. These subdomains are seen in both younger (YA) and older adults (OA), with performance deficits across subdomains in OA. Therefore, our goal was to investigate whether subdomains of EF might be differentially affected by age, and how these differences may relate to broader global age differences in EF.

METHODS

To assess these age differences, we conducted a meta-analysis at multiple levels, including task level, subdomain level, and of global EF. Based on previous work, we hypothesized that there would be overall differences in EF in OA.

RESULTS

Using 1,268 effect sizes from 401 articles, we found overall differences in EF with age. Results suggested that differences in performance are not uniform, such that variability in age effects emerged at the task level, and updating was not as affected by age as other subdomains.

DISCUSSION

These findings advance our understanding of age differences in EF, and stand to inform early detection of EF decline.

Contrasting the Effects of Mortality Salience and Future Time Limitation on Goal Prioritization in Older and Younger Adults

OBJECTIVES

This study aims at contrasting the effects of limited future time perspective and mortality salience on goal prioritization across adulthood. Socioemotional selectivity theory (SST) argues that people increasingly prioritize emotionally meaningful goals when they perceive future time as more limited. Terror management theory (TMT) suggests that mortality salience (i.e., the awareness of one's mortality) drives people to prioritize the goal of perpetuating own existence through affirming cultural worldview.

METHOD

In this study, participants (N = 438) were randomly assigned to six conditions that primed (a) limited future time, (b) mortality salience, (c) death reflection, (d) both limited future time and mortality salience, (e) both limited future time, and death reflection, or (f) none.

RESULTS

Results showed that older adults allocated significantly more resources to emotionally close recipients who supported their cultural worldviews in conditions involving future time limitation and death reflection. They also allocated less resources to emotionally not close recipients who did not support their cultural worldviews in conditions involving future time limitation. Younger adults did not show these differences. Nor did mortality salience have any effect.

DISCUSSION

These results suggest that future time perspective and death reflection shift age-related goals more than mortality salience.

Age-related changes in social decision-making: An electrophysiological analysis of unfairness evaluation in the Ultimatum Game

This study examines age-related differences in behavioral and neural responses to unfairness. Our sample was composed of younger, middle-aged, and older adults, who performed the Ultimatum Game in the proposer role, and in the respondent role during an EEG recording. We administered neurocognitive tests to identify whether patterns in decision-making are associated with age-related changes in cognition. Despite the worse performance in measures of executive functioning, older adults had the best economic strategy by accepting more unfair offers than younger and middle-aged adults. Regarding electrophysiological results, while younger adults showed higher medial frontal negativity (MFN) amplitudes after unfair than after fair offers, middle-aged and older adults had similar amplitudes after both conditions. Our results suggest that aging may be accompanied by an insensitivity to unfairness, which may underlie their higher rates of unfair offers acceptance.

Visual cues of threat elicit greater steady-state electroencephalographic responses than visual reminders of death

Terror management theory (TMT) suggests that reminders of death activate an exclusive anxiety mechanism different from the one activated by other types of symbolic threats. This notion is supported by evidence showing how experimental participants verbally reflecting on their own death are then influenced in their opinions and behaviours. A previous study showed that magnitude of electroencephalography (EEG) activity is greater when images depicting death-related content are coupled with painful thermal stimuli compared to threat-related content. Here we expand on previous research by testing whether similar effects may be brought about by passive observation of generic visual reminders of death. More precisely, we hypothesised that fast periodic presentation of death-related vs. more generic threat-related images determine a preferential modulation of brain activity measured by means of EEG. In two experiments, we found that images depicting death content elicit lower frequency-tagged EEG response compared to more generic threat images. Visual evoked potentials revealed that a brief change of the scene from neutral to threat content elicits greater amplitude at the late latencies (compatible with a P300 potential), particularly at the parieto-occipital sites. Altogether, our findings suggest that, in a context where no reflection on death cues is allowed and no threatening stimuli in other modality occur, visual death cues trigger lower neural synchronisation than that elicited by similarly negative and arousing cues with divergent threatening meaning.

The Last Word: A Comparison of Younger and Older Adults' Brain Responses to Reminders of Death

Objectives

Terror management theory (TMT) suggests increased death awareness motivates various human behaviors and defenses. Recent research reveals age differences in response to increased awareness of death, and older adults' proximity to death may contribute to these differences. In the first known investigation of attention's role in these age differences, we examined brain response associated with attention allocation for death-related stimuli.

Method

Younger (ages 18-28) and older (ages 61-78) adults viewed emotionally neutral, death-related negative, general negative, and positive words while recording event-related potentials (ERPs).

Results

Younger adults exhibited greater amplitudes in the late positive potential component of the ERP in response to death-related than negative words, whereas older adults showed the opposite pattern.

Discussion

Findings provide neurophysiological support for the shift in older adults' responses to death-related stimuli found in other TMT research as well as studies reporting reduced explicit death anxiety in older adults. Results also highlight the importance of considering stimuli content in studies of attention and emotion.

Coping strategies used by the elderly regarding aging and death: an integrative review

Abstract Objective: to identify and synthesize studies that approach the coping strategies used by the elderly to deal with aging and death. Method: an integrative review was performed in seven databases with the following descriptors: psychological adaptation, the elderly, death and aging. Results: 73 articles were identified. After applying the inclusion and exclusion criteria, six articles that identified multiple losses experienced by the elderly and included coping strategies were selected and analyzed. The main losses were: loss of health; physical capacity and functionality; loss in quality of emotional relationships; death of loved ones; reduced social integration; fewer material goods; financial loss; lower cognitive resources; lower perceived mastery; loss of feeling useful; reduction in subjective well-being and quality of life. We also identified the following coping strategies used to deal with losses related to aging and finitude: anticipated grieving; wish to die; isolation; submission; negotiation; acceptance; accommodation; support seeking; living in the moment; seeking spiritual comfort. Conclusion: the elderly experience aging and finitude with coping strategies that can generate both unfavorable and favorable health outcomes. In this context, some coped through anticipated mourning and the desire to die, while others looked for spiritual comfort, social support and acceptance.

Age Differences in the Effects of Mortality Salience on the Correspondence Bias

According to terror management theory, awareness of death affects diverse aspects of human thought and behavior. Studies have shown that older and younger adults differ in how they respond to reminders of their mortality. The present study investigated one hypothesized explanation for these findings: Age-related differences in the tendency to make correspondent inferences. The correspondence bias was assessed in younger and older samples after death-related, negative, or neutral primes. Younger adults displayed increased correspondent inferences following mortality primes, whereas older adults' inferences were not affected by the reminder of death. As in prior research, age differences were evident in control conditions; however, age differences were eliminated in the death condition. Results support the existence of age-related differences in responses to mortality, with only younger adults displaying increased reliance on simplistic information structuring after a death reminder.

Older Adults and the Fear of Death: The Protective Function of Generativity

La théorie de la gestion de terreur (TGT) indique que les visions du monde culturel apaisent les inquiétudes au sujet de la mortalité humaine. Des recherches préliminaires avec des personnes âgées ont indiqué que les personnes âgées ne répondent pas aux rappels de la mort de la même manière que leurs plus jeunes homologues. Le but de l’étude était de tester un concept de développement pertinent qui peut fonctionner comme un tampon contre l’anxiété ressenti à la mort à la fin de vie. L’hypothèse est que le concept de générativité d’ Erikson peut comprendre des propriétés niant de la mort pour les personnes âgées. Cent soixante-dix-neuf personnes âgées ont été recrutés pour déterminer si les initiations* subtiles mais saillants de la mortalité conduirait les participants à évaluer leur propre générativité comme étant plus élevé qu’après les initiations flagrantes, ou pas du tout, après contrôle de la générativité avant l’initiation. Comme prévu, les participants exposés à subtile renforcements de la mort se sont considérés comme ayant des niveaux plus élevés de la générativité que les deux autres groupes après générativité covariable avant. Les explications sont discutées à la lumière de la littérature sur la TGT et la générativité.

Increases in Generative Concern among Older Adults following Reminders of Mortality

According to terror management theory, people are motivated to protect themselves from the potential for anxiety resulting from awareness of mortality. It was hypothesized that increased concern for future generations, and the symbolic immortality this produces, may be particularly important to older adults when awareness of their mortality is increased. In two studies, older and younger adults' generative concern was examined following mortality or control primes. As hypothesized, older adults' generative concern and preference for pro-social over pro-self generativity were greater following reminders of mortality, whereas neither effect was observed among younger adults. For both studies, age differences were only observed when mortality salience was heightened; older and younger adults' generative concern did not differ in control conditions. Results provide support for the hypothesis that younger and older adults differ in their responses to increased awareness of mortality and suggest that older adults respond to death reminders by adopting a more pro-social generative orientation.

Terror management theory applied clinically: implications for existential-integrative psychotherapy

Existential psychotherapy and Terror Management Theory (TMT) offer explanations for the potential psychological effects of death awareness, although their respective literatures bases differ in clarity, research, and implications for treating psychopathology. Existential therapy is often opaque to many therapists, in part due to the lack of consensus on what constitutes its practice, limited published practical examples, and few empirical studies examining its efficacy. By contrast, TMT has an extensive empirical literature base, both within social psychology and spanning multiple disciplines, although previously unexplored within clinical and counseling psychology. This article explores the implications of a proposed TMT integrated existential therapy (TIE), bridging the gap between disciplines in order to meet the needs of the aging population and current challenges facing existential therapists.

Bereavement and anxiety

Bereavement, one of life's most difficult experiences, usually triggers acute grief with yearning and longing for the deceased person that is often intense and preoccupying, along with frequent thoughts and memories of the person who died and relatively little interest in anything unrelated to the deceased loved one. Anxiety is a very common feature of grief that is often neglected. Anxiety is a natural response of the attachment system to separation from a loved one, seen in adults as well as children. Confrontation with one's own death is also a natural trigger of anxiety, though we usually protect ourselves from mortality salience using terror management strategies related to cultural values and self-esteem. In addition, loss of a loved one can trigger the onset of a DSM-IV anxiety disorder that, when present, can derail the mourning process and prolong acute grief. Bereavement-related anxiety disorders need to be recognized and treated.