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Wilson RS, Yu L, Stewart CC, Bennett DA, Boyle PA. Change in Decision-Making Analysis and Preferences in Old Age. J Gerontol B Psychol Sci Soc Sci 2023; 78:1659-1667. [PMID: 36856705 PMCID: PMC10561891 DOI: 10.1093/geronb/gbad037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Indexed: 03/02/2023] Open
Abstract
OBJECTIVES To test the hypotheses that decision making ability declines in old age and that a higher level of cognitive reserve is associated with a reduced rate of decline. METHODS As part of an ongoing cohort study, 982 older adults without dementia at study enrollment completed measures of purpose in life and cognitive activity which were used as markers of cognitive reserve. At annual intervals thereafter, they completed 6 tests of decision making. RESULTS In a factor analysis of baseline decision making scores, 3 measures (financial/health literacy, financial/health decision making, scam susceptibility) loaded on an "analytic" factor and 3 (temporal discounting small stakes, temporal discounting large stakes, risk aversion) loaded on a "preferences" (for temporal discounting and avoiding risk) factor. During a mean of 4.7 years of follow-up (standard deviation = 2.9), analytic factor scores decreased (mean = 0.042-unit per year, standard error [SE] = 0.006, p < .001) and preferences factor scores increased (mean = 0.021-unit per year, SE = 0.006, p < .001), with a correlation of 0.13 (p < .001) between rates of change. Evidence of an association between cognitive reserve and decision making was mixed with purpose in life related to change in analytic decision making, whereas past (but not current) cognitive activity was related to change in decision making preferences. DISCUSSION Decision making analysis and preferences change over time in late life. Change over time in decision making components is relatively independent and differentially related to age and cognitive reserve.
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Affiliation(s)
- Robert S Wilson
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Lei Yu
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Christopher C Stewart
- Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - David A Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA
| | - Patricia A Boyle
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, USA
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Dean LT, Chung SE, Gross AL, Clay OJ, Willis SL, Crowe M, McDonough IM, Thomas KR, Marsiske M, Aysola J, Thorpe RJ, Felix C, Berkowitz M, Coe NB. Does Consumer Credit Precede or Follow Changes in Cognitive Impairment Among Older Adults? An Investigation in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) Trial. J Aging Health 2023; 35:84S-94S. [PMID: 37994853 DOI: 10.1177/08982643221113715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
OBJECTIVES We assessed the relationships between pre- and post-morbid consumer credit history (credit scores, debts unpaid, or in collections) and classification of mild (or greater) cognitive impairment (MCI). METHODS Generalized Estimating Equation models assessed pre-and post-morbid credit history and MCI risk among 1740 participants aged 65+ in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study, linked to TransUnion consumer credit data. RESULTS Each 50-point increase in credit score was associated with up to 8% lower odds of MCI in the next 3 years. In contrast, new unpaid collections over doubled the odds of having MCI in the next 3 years. MCI was associated with subsequent credit score declines and a 47%-71% greater risk of having a new unpaid collection in the next 4 years. DISCUSSION Credit declines may signal risk for future MCI. MCI may lead to financial challenges that warrant credit monitoring interventions for older adults.
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Affiliation(s)
- Lorraine T Dean
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Shang-En Chung
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alden L Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Olivio J Clay
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
- University of Alabama at Birmingham Alzheimer's Disease Research Center, Birmingham, AL, USA
| | | | - Michael Crowe
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ian M McDonough
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
| | - Kelsey R Thomas
- VA San Diego Healthcare System and Department of Psychiatry, San Diego School of Medicine, University of California, San Diego, CA, USA
| | | | - Jaya Aysola
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Roland J Thorpe
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins Alzheimer's Disease Resource Center for Minority Aging Research, Baltimore, MD, USA
| | - Cynthia Felix
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Melissa Berkowitz
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Norma B Coe
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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3
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Compagne C, Gabriel D, Ferrero L, Magnin E, Tannou T. Tools for the Assessment of Risk-Taking Behavior in Older Adults with Mild Dementia: A Cross-Sectional Clinical Study. Brain Sci 2023; 13:967. [PMID: 37371445 DOI: 10.3390/brainsci13060967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/08/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
Diseases such as Alzheimer's cause an alteration of cognitive functions, which can lead to increased daily risk-taking in older adults living at home. The assessment of decision-making abilities is primarily based on clinicians' global analysis. Usual neuropsychological tests such as the MoCA (Montreal Cognitive Assessment) cover most of the cognitive domains and include mental flexibility tasks. Specific behavioral tasks for risk-taking, such as the Balloon Analogue Risk Task (BART) or the Iowa Gambling Task (IGT), have been developed to assess risk-taking behavior, particularly in the field of addictology. Our cross-sectional study aims to determine whether the MoCA global cognitive assessment could be used as a substitute for behavioral tasks in the assessment of risky behavior. In the current study, 24 patients (age: 82.1 ± 5.9) diagnosed with mild dementia completed the cognitive assessment (MoCA and executive function assessment) and two behavioral risk-taking tasks (BART, simplified version of the IGT). Results revealed no relationship between scores obtained in the MoCA and behavioral decision-making tasks. However, the two tasks assessing risk-taking behavior resulted in concordant risk profiles. In addition, patients with a high risk-taking behavior profile on the BART had better Trail Making Test (TMT) scores and thus retained mental flexibility. These findings suggest that MoCA scores are not representative of risk-taking behavioral inclinations. Thus, additional clinical tests should be used to assess risk-taking behavior in geriatric settings. Executive function measures, such as the TMT, and behavioral laboratory measures, such as the BART, are recommended for this purpose.
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Affiliation(s)
- Charline Compagne
- UR LINC, Université de Franche-Comté, 25 000 Besançon, France
- CIC-1431 INSERM, Centre Hospitalier Universitaire, 25 000 Besançon, France
| | - Damien Gabriel
- UR LINC, Université de Franche-Comté, 25 000 Besançon, France
- CIC-1431 INSERM, Centre Hospitalier Universitaire, 25 000 Besançon, France
- Plateforme de Neuroimagerie Fonctionnelle Neuraxess, 25 000 Besançon, France
| | - Lénaïc Ferrero
- CIC-1431 INSERM, Centre Hospitalier Universitaire, 25 000 Besançon, France
| | - Eloi Magnin
- UR LINC, Université de Franche-Comté, 25 000 Besançon, France
- CHU Département de Neurologie, Centre Hospitalier Universitaire, 25 000 Besançon, France
| | - Thomas Tannou
- UR LINC, Université de Franche-Comté, 25 000 Besançon, France
- Plateforme de Neuroimagerie Fonctionnelle Neuraxess, 25 000 Besançon, France
- CIUSS Centre-Sud de l'Ile-de-Montréal, Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, QC H3W 1W5, Canada
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Godefroy V, Sezer I, Bouzigues A, Montembeault M, Koban L, Plassmann H, Migliaccio R. Altered delay discounting in neurodegeneration: insight into the underlying mechanisms and perspectives for clinical applications. Neurosci Biobehav Rev 2023; 146:105048. [PMID: 36669749 DOI: 10.1016/j.neubiorev.2023.105048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 12/12/2022] [Accepted: 01/14/2023] [Indexed: 01/19/2023]
Abstract
Steeper delay discounting (i.e., the extent to which future rewards are perceived as less valuable than immediate ones) has been proposed as a transdiagnostic process across different health conditions, in particular psychiatric disorders. Impulsive decision-making is a hallmark of different neurodegenerative conditions but little is known about delay discounting in the domain of neurodegenerative conditions. We reviewed studies on delay discounting in patients with Parkinson's disease (PD) and in patients with dementia (Alzheimer's disease / AD or frontotemporal dementia / FTD). We proposed that delay discounting could be an early marker of the neurodegenerative process. We developed the idea that altered delay discounting is associated with overlapping but distinct neurocognitive mechanisms across neurodegenerative diseases: dopaminergic-related disorders of reward processing in PD, memory/projection deficits due to medial temporal atrophy in AD, modified reward processing due to orbitofrontal atrophy in FTD. Neurodegeneration could provide a framework to decipher the neuropsychological mechanisms of value-based decision-making. Further, delay discounting could become a marker of interest in clinical practice, in particular for differential diagnosis.
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Affiliation(s)
- Valérie Godefroy
- FrontLab, INSERM U1127, Institut du cerveau, Hôpital Pitié-Salpêtrière, Paris, France; Marketing Area, INSEAD, Fontainebleau, France; Control-Interoception-Attention Team, Paris Brain Institute (ICM), INSERM U 1127, CNRS UMR 7225, Sorbonne University, Paris, France.
| | - Idil Sezer
- FrontLab, INSERM U1127, Institut du cerveau, Hôpital Pitié-Salpêtrière, Paris, France
| | - Arabella Bouzigues
- FrontLab, INSERM U1127, Institut du cerveau, Hôpital Pitié-Salpêtrière, Paris, France
| | - Maxime Montembeault
- Douglas Research Centre, Montréal, Canada; Department of Psychiatry, McGill University, Montréal, Canada
| | - Leonie Koban
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, Bron, France
| | - Hilke Plassmann
- Marketing Area, INSEAD, Fontainebleau, France; Control-Interoception-Attention Team, Paris Brain Institute (ICM), INSERM U 1127, CNRS UMR 7225, Sorbonne University, Paris, France
| | - Raffaella Migliaccio
- FrontLab, INSERM U1127, Institut du cerveau, Hôpital Pitié-Salpêtrière, Paris, France; Centre de Référence des Démences Rares ou Précoces, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France; Institute of Memory and Alzheimer's Disease, Centre of Excellence of Neurodegenerative Disease, Department of Neurology, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.
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Age-Related Changes in Risky Decision Making and Associated Neural Circuitry in a Rat Model. eNeuro 2023; 10:ENEURO.0385-22.2022. [PMID: 36596593 PMCID: PMC9840382 DOI: 10.1523/eneuro.0385-22.2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 12/07/2022] [Accepted: 12/13/2022] [Indexed: 01/05/2023] Open
Abstract
Altered decision making at advanced ages can have a significant impact on an individual's quality of life and the ability to maintain personal independence. Relative to young adults, older adults make less impulsive and less risky choices; although these changes in decision making could be considered beneficial, they can also lead to choices with potentially negative consequences (e.g., avoidance of medical procedures). Rodent models of decision making have been invaluable for dissecting cognitive and neurobiological mechanisms that contribute to age-related changes in decision making, but they have predominantly used costs related to timing or probability of reward delivery and have not considered other equally important costs, such as the risk of adverse consequences. The current study therefore used a rat model of decision making involving risk of explicit punishment to examine age-related changes in this form of choice behavior in male rats, and to identify potential cognitive and neurobiological mechanisms that contribute to these changes. Relative to young rats, aged rats displayed greater risk aversion, which was not attributable to reduced motivation for food, changes in shock sensitivity, or impaired cognitive flexibility. Functional MRI analyses revealed that, overall, functional connectivity was greater in aged rats compared with young rats, particularly among brain regions implicated in risky decision making such as basolateral amygdala, orbitofrontal cortex, and ventral tegmental area. Collectively, these findings are consistent with greater risk aversion found in older humans, and reveal age-related changes in brain connectivity.
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Hughes JM, Brown RT, Fanning J, Raj M, Bisson ANS, Ghneim M, Kritchevsky SB. Achieving and sustaining behavior change for older adults: A Research Centers Collaborative Network workshop report. THE GERONTOLOGIST 2022; 63:gnac173. [PMID: 36473052 PMCID: PMC10474593 DOI: 10.1093/geront/gnac173] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Indexed: 09/04/2023] Open
Abstract
Modifying unhealthy behaviors and/or environments may improve or maintain an older adult's health. However, achieving and sustaining behavior change is challenging and depends upon clinical, social, psychological, and political domains. In an effort to highlight the multidisciplinary nature of behavior change, the NIA Research Centers Collaborative Network (RCCN) held a two-day workshop, Achieving and sustaining behavior change for older adults. The workshop was informed by the socioecological model and designed to initiate dialogue around individual, community, and systems-level determinants of behavior change. This paper summarizes key topics presented during the workshop, discusses opportunities for future research, education, and training, and recommends how each of the six NIA research centers may pursue work in behavior change for older adults.
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Affiliation(s)
- Jaime M Hughes
- Department of Implementation Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Rebecca T Brown
- Division of Geriatric Medicine, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, USA
| | - Jason Fanning
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina, USA
| | - Minakshi Raj
- Department of Kinesiology and Community Health, University of Illinois, Champaign, Illinois, USA
| | - Alycia N S Bisson
- Department of Kinesiology and Community health, University of Illinois Urbana Champaign, Champaign, Illinois, USA
| | - Mira Ghneim
- R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Stephen B Kritchevsky
- Sticht Center on Healthy Aging and Alzheimer’s Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
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Lindquist LA, Miller‐Winder AP, Schierer A, Murawski A, Opsasnick L, Curtis LM, Kim K, Ramirez‐Zohfeld V. Aspects of cognition that impact aging-in-place and long-term care planning. J Am Geriatr Soc 2022; 70:2646-2652. [PMID: 35726136 PMCID: PMC9489627 DOI: 10.1111/jgs.17927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/10/2022] [Accepted: 05/19/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Older adults frequently defer decisions about their aging-in-place/long-term care (AIP-LTC) needs. As a result, when older adults experience worsening Alzheimer's disease, family members/friends become surrogate decision makers. We sought to understand what aspects of cognition impact older adult AIP-LTC planning. METHODS As part of the PlanYourLifespan (PYL)-LitCog study, we longitudinally examined AIP-LTC decision-making among a cohort (LitCog) of community-based older adults (65 years and older) recruited from hospital-associated primary care clinics in Chicago, Illinois, with extensive cognitive testing. PlanYourLifespan.org (PYL) is an evidence-based online intervention that facilitates AIP-LTC planning. Subjects underwent baseline testing, received the PYL online intervention, and then were surveyed at 1, 6, and 12 months about AIP-LTC decision-making. Cross-sectional logistic regression analysis was conducted examining cognitive variables that impacted AIP-LTC decision-making. RESULTS Of the 293 older adults interviewed (mean age 73.0 years, 40.4% non-White), subjects were more likely to have made AIP-LTC decisions if they had adequate inductive reasoning (ETS letter sets total-OR = 1.14 (95% CI = 1.03-1.27; p < 0.05)) and adequate working memory (size judgment span total-OR = 1.76 (95% CI = 1.13-2.73; p < 0.05)). There were no differences in decision-making observed in verbal abilities, long-term memory, or processing speed. All analyses were adjusted for participant gender, race, age, and decision-making response at baseline. CONCLUSION Inductive reasoning and working memory are critical to AIP-LTC decision-making. Screening routinely for these specific cognitive domains is important in targeting and helping older adults prepare in time for their future AIP-LTC needs.
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Affiliation(s)
- Lee A. Lindquist
- Division of Geriatrics, Feinberg School of MedicineNorthwestern UniversityChicagoIllinois
| | - Amber P. Miller‐Winder
- Division of Geriatrics, Feinberg School of MedicineNorthwestern UniversityChicagoIllinois
| | - Allison Schierer
- Division of Geriatrics, Feinberg School of MedicineNorthwestern UniversityChicagoIllinois
| | - Alaine Murawski
- Division of Geriatrics, Feinberg School of MedicineNorthwestern UniversityChicagoIllinois
| | - Lauren Opsasnick
- Division of Geriatrics, Feinberg School of MedicineNorthwestern UniversityChicagoIllinois
| | - Laura M. Curtis
- Division of Geriatrics, Feinberg School of MedicineNorthwestern UniversityChicagoIllinois
| | - Kwang‐Youn Kim
- Division of Preventative MedicineNorthwestern UniversityChicagoIllinoisUSA
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Relationship of the balloon analog risk task to neurocognitive impairment differs by HIV serostatus and history of major depressive disorder. J Neurovirol 2022; 28:248-264. [PMID: 34981438 PMCID: PMC9187559 DOI: 10.1007/s13365-021-01046-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 11/11/2021] [Accepted: 12/16/2021] [Indexed: 12/27/2022]
Abstract
HIV and major depressive disorder (MDD) commonly co-occur and are both linked to greater risk-taking behavior, possibly due to neurocognitive impairment (NCI). The present study examined the concordance of the Balloon Analog Risk Task (BART), a gold standard measure of risk-taking propensity, with NCI and real-world sexual risk behaviors in PWH with comorbid MDD. Participants included 259 adults, stratified by HIV serostatus (HIV + /HIV −) and lifetime MDD (MDD + /MDD −), who completed neuropsychological testing, the BART, and sexual risk behavior questionnaires. Logistic regression, stratified by HIV serostatus, examined joint effects of MDD and BART (linear and quadratic) on NCI. Follow-up linear regressions examined sexual risk behavior and neurocognitive domain T-scores as correlates of the BART. NCI prevalence was lowest in HIV − /MDD − , but BART scores did not differ by HIV/MDD status. In the HIV + group, BART performance predicted NCI such that high and low BART scores related to greater odds of NCI, but only in dual-risk HIV + /MDD + individuals. HIV + /MDD + individuals with both low and high BART scores exhibited poorer learning and recall, whereas processing speed and executive function were only poor in low BART risk-taking HIV + /MDD + . Higher BART scores linearly related to higher sexual risk behaviors only in MDD + individuals, independent of HIV serostatus. Low and high risk-taking on the BART may reflect discrete neurocognitive profiles in HIV + /MDD + individuals, with differential implications for real-world sexual risk behavior. HIV and comorbid MDD may disturb corticostriatal circuits responsible for integrating affective and neurocognitive components of decision-making, thereby contributing to risk-averse and risk-taking phenotypes.
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An R, Li D, McCaffrey J, Khan N. Whole egg consumption and cognitive function among US older adults. J Hum Nutr Diet 2021; 35:554-565. [PMID: 34841618 DOI: 10.1111/jhn.12970] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/23/2021] [Accepted: 11/05/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Eggs are an affordable food providing many shortfall nutrients with the potential to improve cognitive health. We assessed the relationship between whole egg consumption and cognitive functioning among a US nationally representative sample of older adults. METHODS Individual-level data (2816 adults, aged ≥ 60 years) were obtained from the National Health and Nutrition Examination Survey (NHANES) 2011-2012 and 2013-2014 waves. Cognitive assessments included the Consortium to Establish a Registry for Alzheimer's Disease Word List Learning Test (CERAD-WL), Word List Recall Test (CERAD-DR), Animal Fluency Test (AF) and Digit Symbol Substitution Test (DSST). A composite cognitive z-score was constructed based on the individual tests to represent one's overall cognitive functioning. Multiple linear and logistic regressions were performed to examine the effect of whole egg consumption on cognitive functioning, adjusting for individual characteristics and survey design. RESULTS Approximately 57% of older adults consumed whole eggs, with an average daily intake of 34 g of whole egg equivalent among consumers. The average z-scores of the CERAD-WL, CERAD-DR, AF and DSST tests were -0.08, 0.23, 0.37 and 0.42, respectively, and the overall composite cognitive z-score was 0.24 among older adults. Regression analyses found that neither whole egg consumption status, nor daily intake quantity was associated with cognitive test scores. CONCLUSIONS No association was found between whole egg consumption and cognitive functioning among US older adults. Study limitations included cross-sectional study design and measurement errors. Future studies with longitudinal or experimental design are warranted to examine the possible link between egg consumption and cognition in older adults.
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Affiliation(s)
- Ruopeng An
- Department of Brown School, Washington University, St. Louis, Missouri, USA
| | - Danyi Li
- Department of Brown School, Washington University, St. Louis, Missouri, USA
| | - Jennifer McCaffrey
- Office of Extension and Outreach, University of Illinois, Champaign, Illinois, USA
| | - Naiman Khan
- Department of Kinesiology and Community Health, University of Illinois, Champaign, Illinois, USA
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van den Berk-Clark C, Pickard J, Davis D, Scherrer JF. The Role of Impulsive Decision Making on Health Behavior Related to Cardiovascular Disease Risk Among Older Adults With Hypertension. J Gerontol Nurs 2021; 47:22-30. [PMID: 34704864 DOI: 10.3928/00989134-20211013-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The purpose of the current study was to investigate whether older adults who are more impulsive also tend to engage in more health behaviors associated with increased risk for cardiovascular disease (CVD). We analyzed data from the Health and Retirement Study. Logistic regression analysis was performed to determine the likelihood of medication adherence, alcohol consumption, and exercise among older adults with hypertension. Adjusted regression results revealed higher impulsive decision making was associated with greater likelihood of obesity (odds ratio [OR] = 2.96, 95% confidence interval [CI] [1.00, 8.92]), lower likelihood of medication adherence (OR = 0.37, 95% CI [0.15, 0.92]), and regular drinking (OR = 0.36, 95% CI [0.15, 0.87]). Higher impulsive decision making was associated with lower likelihood of regular exercise only in unadjusted models. Older adults with hypertension who had higher impulsive decision making engaged in health behaviors associated with increased risk for CVD. Health care providers should consider the range of strategies offered through behavioral economics to improve health in these at-risk populations. [Journal of Gerontological Nursing, 47(11), 22-30.].
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Han SD, Barnes LL, Leurgans S, Yu L, Stewart CC, Lamar M, Glover CM, Bennett DA, Boyle PA. Susceptibility to Scams in Older Black and White Adults. Front Psychol 2021; 12:685258. [PMID: 34322065 PMCID: PMC8311557 DOI: 10.3389/fpsyg.2021.685258] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 06/11/2021] [Indexed: 11/13/2022] Open
Abstract
Previous reports on racial differences in scam susceptibility have yielded mixed findings, and few studies have examined reasons for any observed race differences. Older Black and White participants without dementia (N = 592) from the Minority Aging Research Study and the Rush Memory and Aging Project who completed a susceptibility to scam questionnaire and other measures were matched according to age, education, sex, and global cognition using Mahalanobis distance. In adjusted models, older Black adults were less susceptible to scams than older White adults (Beta = -0.2496, SE = 0.0649, p = 0.0001). Contextual factors did not mediate and affective factors did not moderate this association. Analyses of specific items revealed Black adults had greater knowledge of scam targeting of older adults and were less likely to pick up the phone for unidentified callers. Older Black adults are less susceptible to scams than demographically-matched older White adults, although the reasons remain unknown.
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Affiliation(s)
- S Duke Han
- Department of Family Medicine, University of Southern California, Los Angeles, CA, United States.,Department of Neurology, University of Southern California, Los Angeles, CA, United States.,Department of Psychology, University of Southern California, Los Angeles, CA, United States.,School of Gerontology, University of Southern California, Los Angeles, CA, United States.,Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States.,Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Lisa L Barnes
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States.,Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Sue Leurgans
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Christopher C Stewart
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Melissa Lamar
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States.,Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States
| | - Crystal M Glover
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States.,Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Patricia A Boyle
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States.,Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States
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Lindquist LA, Muhammad R, Miller-Winder AP, Opsasnick L, Kim KY, Benavente JY, Wolf M, Ramirez-Zohfeld V. Rationale and study design for decision making & implementation of aging-in-place/long term care plans among older adults. Contemp Clin Trials Commun 2021; 22:100756. [PMID: 33869887 PMCID: PMC8040099 DOI: 10.1016/j.conctc.2021.100756] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 02/06/2021] [Accepted: 03/02/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Remaining in one's own home and community is a priority for many older adults as they age. Decision-making and planning is critical to ensure successful aging-in-place (AIP), especially when individuals experience age-related changes such as cognitive decline. Objectives: We are testing how decision-making and planning for AIP is impacted by changes in older adults' cognition and function, chronic conditions, social influences, environmental factors and identifying the mediating/moderating interactions between factors. We will also assess whether decision-making and planning for AIP translates into timely adoption of plans and goal concordance between older adults and their surrogate/caregiver decision makers. METHODS We will conduct a longitudinal single-group interventional clinical trial of community-dwelling older adults who are enrolled in LitCog, (R01AG03611) and expose them to an online intervention, PlanYourLifespan.org, which facilitates decision-making and planning for AIP. Enrolled participants (n = 398) will complete interviews at baseline, one month, and every six months up to 42 months in conjunction with the LitCog study, where cognitive, social, functional, and health literacy data is collected. Additionally, we will collect data on decision-making, resource use, communication of plans, timing of plan implementation, and goal concordance. PROJECTED OUTCOMES Findings from this study may generate evidence on how age-related changes in older adults may affect decision-making and implementation in relation to AIP as well as the impact of social relationships and support. Ultimately these findings may help shape the design of programs and practices that may improve the lives of older adults and the capacity of institutions to adapt to societal aging and AIP.
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Affiliation(s)
- Lee A. Lindquist
- Division of General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Ruqayyah Muhammad
- Division of General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Amber P. Miller-Winder
- Division of General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Lauren Opsasnick
- Division of General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Kwang-Youn Kim
- Division of General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Julia Yoshino Benavente
- Division of General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Michael Wolf
- Division of General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Vanessa Ramirez-Zohfeld
- Division of General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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13
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Keidel K, Rramani Q, Weber B, Murawski C, Ettinger U. Individual Differences in Intertemporal Choice. Front Psychol 2021; 12:643670. [PMID: 33935897 PMCID: PMC8085593 DOI: 10.3389/fpsyg.2021.643670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/08/2021] [Indexed: 11/23/2022] Open
Abstract
Intertemporal choice involves deciding between smaller, sooner and larger, later rewards. People tend to prefer smaller rewards that are available earlier to larger rewards available later, a phenomenon referred to as temporal or delay discounting. Despite its ubiquity in human and non-human animals, temporal discounting is subject to considerable individual differences. Here, we provide a critical narrative review of this literature and make suggestions for future work. We conclude that temporal discounting is associated with key socio-economic and health-related variables. Regarding personality, large-scale studies have found steeper temporal discounting to be associated with higher levels of self-reported impulsivity and extraversion; however, effect sizes are small. Temporal discounting correlates negatively with future-oriented cognitive styles and inhibitory control, again with small effect sizes. There are consistent associations between steeper temporal discounting and lower intelligence, with effect sizes exceeding those of personality or cognitive variables, although socio-demographic moderator variables may play a role. Neuroimaging evidence of brain structural and functional correlates is not yet consistent, neither with regard to areas nor directions of effects. Finally, following early candidate gene studies, recent Genome Wide Association Study (GWAS) approaches have revealed the molecular genetic architecture of temporal discounting to be more complex than initially thought. Overall, the study of individual differences in temporal discounting is a maturing field that has produced some replicable findings. Effect sizes are small-to-medium, necessitating future hypothesis-driven work that prioritizes large samples with adequate power calculations. More research is also needed regarding the neural origins of individual differences in temporal discounting as well as the mediating neural mechanisms of associations of temporal discounting with personality and cognitive variables.
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Affiliation(s)
- Kristof Keidel
- Department of Psychology, University of Bonn, Bonn, Germany
- Department of Finance, The University of Melbourne, Melbourne, VIC, Australia
| | - Qëndresa Rramani
- Center for Economics and Neuroscience, University of Bonn, Bonn, Germany
- Institute of Experimental Epileptology and Cognition Research, University of Bonn, Bonn, Germany
| | - Bernd Weber
- Center for Economics and Neuroscience, University of Bonn, Bonn, Germany
- Institute of Experimental Epileptology and Cognition Research, University of Bonn, Bonn, Germany
| | - Carsten Murawski
- Department of Finance, The University of Melbourne, Melbourne, VIC, Australia
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14
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Oba H, Kadoya Y, Okamoto H, Matsuoka T, Abe Y, Shibata K, Narumoto J. The Economic Burden of Dementia: Evidence from a Survey of Households of People with Dementia and Their Caregivers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052717. [PMID: 33800246 PMCID: PMC7967439 DOI: 10.3390/ijerph18052717] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 02/26/2021] [Accepted: 03/02/2021] [Indexed: 01/22/2023]
Abstract
Although a cognitive impairment such as dementia causes serious economic problems among older people, its impact on economic activities is unclear. This study investigated the actual conditions of economic activities and the current status of the financial support systems among people with dementia and caregivers. One hundred and five dyads participated in the survey. Each dyad consisted of an older person with Alzheimer’s disease and their caregiver. The Mini-Mental State Examination (MMSE) and Functional Assessment Staging (FAST) were used to evaluate the cognitive functions of people with dementia. The caregivers were asked questions concerning the financial status of the household and their utilization of the financial support systems available to people with dementia. Average monthly care costs significantly increased according to the severity of dementia, while household income and spending incurred no significant changes. People with dementia experienced financial problems (including a large amount of erroneously purchased, unnecessary shopping), even though their assets were informally managed by their caregivers. Financial support systems such as adult guardianship and civil trust systems were rarely known and used. We proposed the propagation of the adult guardianship and civil trust systems and the development of contract guidelines for elderly customers including people with dementia.
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Affiliation(s)
- Hikaru Oba
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (H.O.); (T.M.); (Y.A.); (K.S.); (J.N.)
- Graduate School of Human Sciences, Osaka University, Osaka 565-0871, Japan
- Correspondence: ; Tel.: +81-75-251-5612
| | - Yoshihiko Kadoya
- School of Economics, Hiroshima University, Hiroshima 739-8525, Japan;
| | - Haruka Okamoto
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (H.O.); (T.M.); (Y.A.); (K.S.); (J.N.)
| | - Teruyuki Matsuoka
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (H.O.); (T.M.); (Y.A.); (K.S.); (J.N.)
| | - Yoshinari Abe
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (H.O.); (T.M.); (Y.A.); (K.S.); (J.N.)
| | - Keisuke Shibata
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (H.O.); (T.M.); (Y.A.); (K.S.); (J.N.)
| | - Jin Narumoto
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; (H.O.); (T.M.); (Y.A.); (K.S.); (J.N.)
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15
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Young NA, Minton AR, Mikels JA. The Appraisal Approach to Aging and Emotion: An Integrative Theoretical Framework. DEVELOPMENTAL REVIEW 2021; 59:100947. [PMID: 33737760 PMCID: PMC7963263 DOI: 10.1016/j.dr.2021.100947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
To advance our understanding of how emotional experience changes across the adult life span, we propose an integrative theoretical framework: the appraisal approach to aging and emotion (AAAE). AAAE posits that (a) age-related cognitive, motivational, and physical changes fundamentally change the appraisal system in certain ways, and that (b) older adults often deploy appraisal processes in different ways relative to their younger counterparts. As such, we hypothesize that these age-related changes to the appraisal process underlie the finding that older and younger adults tend to experience different emotions. In this paper we integrate findings from the aging literature with appraisal theory, grounding AAAE in theoretical and empirical work relevant to the relationship between aging and appraisal processes. Using our theoretical framework, it is possible to identify critical points of investigation for aging and emotion researchers to further develop our understanding of the proximal-level determinants of age differences in emotion.
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16
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Lempert KM, Mechanic-Hamilton DJ, Xie L, Wisse LEM, de Flores R, Wang J, Das SR, Yushkevich PA, Wolk DA, Kable JW. Neural and behavioral correlates of episodic memory are associated with temporal discounting in older adults. Neuropsychologia 2020; 146:107549. [PMID: 32621907 DOI: 10.1016/j.neuropsychologia.2020.107549] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 06/28/2020] [Accepted: 06/29/2020] [Indexed: 01/22/2023]
Abstract
When facing decisions involving trade-offs between smaller, sooner and larger, delayed rewards, people tend to discount the value of future rewards. There are substantial individual differences in this tendency toward temporal discounting, however. One neurocognitive system that may underlie these individual differences is episodic memory, given the overlap in the neural circuitry involved in imagining the future and remembering the past. Here we tested this hypothesis in older adults, including both those that were cognitively normal and those with amnestic mild cognitive impairment (MCI). We found that performance on neuropsychological measures of episodic memory retrieval was associated with temporal discounting, such that people with better memory discounted delayed rewards less. This relationship was specific to episodic memory and temporal discounting, since executive function (another cognitive ability) was unrelated to temporal discounting, and episodic memory was unrelated to risk tolerance (another decision-making preference). We also examined cortical thickness and volume in medial temporal lobe regions critical for episodic memory. Entorhinal cortical thickness was associated with reduced temporal discounting, with episodic memory performance partially mediating this association. The inclusion of MCI participants was critical to revealing these associations between episodic memory and entorhinal cortical thickness and temporal discounting. These effects were larger in the MCI group, reduced after controlling for MCI status, and statistically significant only when including MCI participants in analyses. Overall, these findings suggest that individual differences in temporal discounting are driven by episodic memory function, and that a decline in medial temporal lobe structural integrity may impact temporal discounting.
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Affiliation(s)
- Karolina M Lempert
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Dawn J Mechanic-Hamilton
- Penn Memory Center, University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Neurology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Long Xie
- Penn Image Computing and Science Laboratory (PICSL), University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Laura E M Wisse
- Penn Image Computing and Science Laboratory (PICSL), University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Robin de Flores
- Penn Image Computing and Science Laboratory (PICSL), University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Jieqiong Wang
- Penn Image Computing and Science Laboratory (PICSL), University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Sandhitsu R Das
- Penn Image Computing and Science Laboratory (PICSL), University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Paul A Yushkevich
- Penn Image Computing and Science Laboratory (PICSL), University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - David A Wolk
- Penn Memory Center, University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Neurology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Joseph W Kable
- Department of Psychology, University of Pennsylvania, Philadelphia, PA, 19104, USA.
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17
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Hatta T, Hotta C, Kato K, Hatta T, Hatta J, Fujiwara K, Iwahara A. Dissociation in Age-Related Developmental Trajectories Between Phonetic Fluency and Semantic Fluency Tests: Analysis of Longitudinal Data From the Yakumo Study. AMERICAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.5406/amerjpsyc.133.2.0197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Possible age-related differences in Phonemic Fluency Test (PFT) and Semantic Fluency Test (SFT) performance were examined by using longitudinal data of healthy older adults. The performance trajectories of 81 older adults in the 2 tests were analyzed for 11 years, from 65 to 75 years of age, via individually calculated linear regression coefficients. The results indicated that the PFT and SFT performance showed an age-related decline. However, the declining slope of the SFT was steeper than that of the PFT performance. These findings correspond with those of previous cross-sectional studies and suggest a future need to examine neurobiological substrates underlying the two domains of verbal fluency abilities.
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18
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El Haj M, Boutoleau-Bretonnière C, Moustafa A, Allain P. The discounted future: Relationship between temporal discounting and future thinking in Alzheimer's disease. APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:412-418. [PMID: 32429783 DOI: 10.1080/23279095.2020.1764958] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Temporal discounting refers to the tendency to prefer smaller sooner rewards over larger later rewards. Prior research has reported temporal discounting in Alzheimer's disease (AD). We thus investigated, in this study, the relationship between temporal discounting and future thinking in AD. The study included 40 patients with AD and 42 control participants. We invited participants, on a temporal discounting task, to choose between an immediate but smaller or a delayed but larger amount of money (e.g. "would you prefer 10 dollars today or 50 dollars after one month?"). We also invited the participants to imagine events that may happen in the future, a task known as future thinking. Analysis demonstrated a bias toward immediate rewards (i.e. temporal discounting) as well as difficulties to imagine specific future events in patients with AD. Critically, temporal discounting and future thinking in AD were significantly correlated. Generally speaking, a lack of thinking about the future may lead to impulsive behavior. More specifically, decline in future thinking in AD may limit the ability of patients to project themselves in time to consider outcomes of their decisions, resulting in a tendency to devaluate future rewards in favor of more imminent ones (i.e. temporal discounting).
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Affiliation(s)
- Mohamad El Haj
- Laboratoire de Psychologie des Pays de la Loire, Nantes Université, Univ Angers, Nantes, France.,Centre Hospitalier de Tourcoing, Unité de Gériatrie, Tourcoing, France.,Institut Universitaire de France, Paris, France
| | | | - Ahmed Moustafa
- School of Psychology and Marcs Institute for Brain and Behaviour, Western Sydney University, Sydney, Australia
| | - Philippe Allain
- Laboratoire de Psychologie des Pays de la Loire, Maison de la recherche Germaine Tillion, UNIV Angers, Nantes Université, Angers, France.,Département de Neurologie, CHU Angers, Angers, France
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19
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El Haj M, Boutoleau-Bretonnière C, Allain P. Memory of decisions: Relationship between decline of autobiographical memory and temporal discounting in Alzheimer's disease. J Clin Exp Neuropsychol 2020; 42:415-424. [PMID: 32223584 DOI: 10.1080/13803395.2020.1744527] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Temporal discounting refers to the tendency to attribute higher value to a reward received early than to one received later. We evaluated this tendency in patients with Alzheimer's Disease. We also evaluated whether temporal discounting is associated with decline in autobiographical memory (i.e., the ability to remember past personal experiences), with executive dysfunction, and/or with general cognitive decline. We invited patients with AD and control participants to answer binary questions involving the choice between receiving a smaller amount of money earlier or a larger one later (e.g., "Which do you prefer, 10 euros in cash right now or 50 euros in a month?"). Results demonstrated higher temporal discounting in patients with AD than in control participants. Temporal discounting was significantly correlated with decline in AM and general cognitive decline but not with executive dysfunction in patients with AD. The tendency to decide based on immediate rewards (i.e., temporal discounting) in AD is related with difficulty in remembering information about experiences of previous decisions, and/or their consequences (i.e., decline in autobiographical memory).
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Affiliation(s)
- Mohamad El Haj
- Nantes Université, Univ Angers, Laboratoire de Psychologie des Pays de la Loire (LPPL - EA 4638), Nantes, France.,Unité de Gériatrie, Centre Hospitalier de Tourcoing, Tourcoing, France.,Institut Universitaire de France, Paris, France
| | | | - Philippe Allain
- Laboratoire de Psychologie des Pays de la Loire, LPPL EA 4638, SFR Confluences, UNIV Angers, Nantes Université, Maison de la Recherche Germaine Tillion, Angers, France
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20
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Geng Z, Wu X, Wang L, Zhou S, Tian Y, Wang K, Wei L. Reduced delayed reward selection by Alzheimer’s disease and mild cognitive impairment patients during intertemporal decision-making. J Clin Exp Neuropsychol 2020; 42:298-306. [PMID: 31914851 DOI: 10.1080/13803395.2020.1711873] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Zhi Geng
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Xingqi Wu
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Lu Wang
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Shanshan Zhou
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
- Collaborative Innovation Centre of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Yanghua Tian
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
- Collaborative Innovation Centre of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Kai Wang
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
- Collaborative Innovation Centre of Neuropsychiatric Disorders and Mental Health, Hefei, China
| | - Ling Wei
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
- Collaborative Innovation Centre of Neuropsychiatric Disorders and Mental Health, Hefei, China
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21
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Oba H, Kadoya Y, Matsuoka T, Narumoto J. Cognitive decline reduces household spending among older people. Psychogeriatrics 2020; 20:28-34. [PMID: 30941819 DOI: 10.1111/psyg.12453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 02/14/2019] [Accepted: 03/05/2019] [Indexed: 11/29/2022]
Abstract
AIM The purpose of the present study was to investigate the effect of cognitive decline on household spending. METHODS The panel data covered the years 2007-2009 and were taken from the Japanese Study of Aging and Retirement, with data extracted for 253 participants aged 65 years and over. Sociodemographic characteristics, functional status, depressive symptoms, and monthly household spending excluding spending for shelter (e.g. mortgage) were used in the analysis. Cognitive function was evaluated by delayed recall and serial 7s and represented by the sum of both scores. Changes in spending and cognitive function scores were calculated by subtracting 2007 scores from 2009 scores. Participants were divided into two groups: cognitive decline and no cognitive decline. The effect of cognitive decline on changes in household spending was estimated. RESULTS Although the cognitive decline group had more severe depressive symptoms than the no cognitive decline group in 2009, cognitive decline was the only factor related to change in household spending. CONCLUSION The results imply that cognitive decline may cause a decline in household spending in older people. Focusing on changes in household spending behaviour might help detect cognitive impairment in older people.
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Affiliation(s)
- Hikaru Oba
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.,Japan Society for the Promotion of Science, Tokyo, Japan
| | | | - Teruyuki Matsuoka
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Jin Narumoto
- Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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22
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The role of cognitive reflection in decision making: Evidence from Pakistani managers. JUDGMENT AND DECISION MAKING 2019. [DOI: 10.1017/s1930297500004885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
AbstractAssessing how managers discount and evaluate risks is crucial in designing effective managerial policies. In this work, we examine whether risk preferences (RP; both in the domains of gain and loss) and time preferences (TP) are related to managers’ cognitive reflection (CR). To achieve this, the current study focuses on the responses of 601 corporate decision-makers, such as CEO and CFO, of 200 non-financial firms listed at the Pakistan Stock Exchange. Using the three-item of Cognitive Reflection Test (CRT; Frederick, 2005) as a measure of CR, we observe that males perform better on this test than females. Correlation analysis reveals that individuals’ RP in the gain domain are positively associated with their TP, implying that risk-taking individuals are more patient. Our evidence further shows that higher CR is associated with a higher likelihood of increased patience and a lower likelihood of willingness to take risks in the domain of loss. Greater CR is also linked to a higher likelihood of risk-taking in the domain of gain. These findings have important implications regarding the ability of managers to make financial decisions that involve uncertainty and delayed rewards but maximize firm value.
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23
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Wilson RS, Yu L, Schneider JA, Bennett DA, Boyle PA. Risk Aversion and Alzheimer Disease in Old Age. Am J Geriatr Psychiatry 2019; 27:851-861. [PMID: 30982702 PMCID: PMC9768688 DOI: 10.1016/j.jagp.2019.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 02/05/2019] [Accepted: 02/16/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To test the hypothesis that late-life risk aversion is partly a prodromal sign of dementia. METHODS The authors' design was a longitudinal clinical-pathologic cohort study. The setting included participants' residences in the Chicago area, and a total of 874 older persons without dementia were enrolled. At baseline, risk aversion was assessed with questions involving choices between certain smaller rewards and uncertain larger rewards. At annual intervals thereafter, participants underwent evaluations that included cognitive testing and diagnosis of mild cognitive impairment (MCI) and dementia. At death, a neuropathologic examination was done to quantify common pathologies linked to dementia. RESULTS Risk aversion at study onset ranged from 0.05-0.91 (mean: 0.32, standard deviation: 0.31). During a mean of 4.6 years of follow-up, 123 (of 874) developed dementia. Higher risk aversion was associated with higher dementia incidence (hazard ratio [HR]: 2.08; 95% confidence interval: 1.18, 3.65) and more rapid decline in episodic (estimate: -0.062; standard error [SE]: 0.019; t [3677]: -3.33; p < 0.001) and semantic (estimate: -0.039; SE: 0.015; t [3655]: -2.61; p = 0.009) memory but not in other cognitive systems. Of 702 people without cognitive impairment at baseline, 223 developed incident MCI. Higher risk aversion was associated with higher incidence of MCI (HR: 2.10; 95% confidence interval: 1.34, 3.29) and more rapid episodic memory decline. In 181 neuropathologically examined individuals, higher risk aversion was associated with higher levels of plaques, tangles, and cerebral amyloid angiopathy. CONCLUSION The results support the hypothesis that high risk aversion in old age is partly an early sign of the pathology of Alzheimer disease.
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Affiliation(s)
- Robert S Wilson
- Rush Alzheimer's Disease Center and Departments of Neurological Sciences, (RSW, LY, JAS, DAB); Behavioral Sciences (RSW, PAB).
| | - Lei Yu
- Rush Alzheimer's Disease Center and Departments of Neurological Sciences, (RSW, LY, JAS, DAB)
| | - Julie A Schneider
- Rush Alzheimer's Disease Center and Departments of Neurological Sciences, (RSW, LY, JAS, DAB); Pathology (JAS), Rush University Medical Center, Chicago
| | - David A Bennett
- Rush Alzheimer's Disease Center and Departments of Neurological Sciences, (RSW, LY, JAS, DAB)
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24
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Bixter MT, Rogers WA. Age‐related differences in delay discounting: Immediate reward, reward magnitude, and social influence. JOURNAL OF BEHAVIORAL DECISION MAKING 2019. [DOI: 10.1002/bdm.2124] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | - Wendy A. Rogers
- Department of Kinesiology and Community HealthUniversity of Illinois Urbana‐Champaign Champaign IL USA
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25
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Grunst AS, Grunst ML, Pinxten R, Eens M. Personality and plasticity in neophobia levels vary with anthropogenic disturbance but not toxic metal exposure in urban great tits: Urban disturbance, metal pollution and neophobia. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 656:997-1009. [PMID: 30625686 DOI: 10.1016/j.scitotenv.2018.11.383] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 11/23/2018] [Accepted: 11/25/2018] [Indexed: 06/09/2023]
Abstract
Animal personalities, as defined by repeatable among individual differences in behavior, can vary across urbanization gradients. However, how urbanization affects personalities remains incompletely understood, especially because different urban stressors could affect personality traits in opposing ways, whereas most previous studies have considered only one urban disturbance factor. For instance, novel habitat features could favor reduced neophobia, whereas exposure to pollutants could increase risk sensitivity through neurotoxic or hormonal effects. To address this contingency, we studied object neophobia in four urban populations of great tits (Parus major) that vary in exposure to metal pollution and anthropogenic disturbance, as quantified by proximity to roads and pathways. We measured the return latency of incubating females when flushed from the nest and presented with up to two different novel objects, allowing quantification of behavioral repeatability and plasticity. To separate neophobia from sensitivity to disturbance, we also conducted baseline trials, in which females were flushed but no object was presented. We additionally measured exploration behavior and aggression (hissing) during nest defense, to explore whether suites of behaviors covary with urbanization, and examined whether neophobia affects reproductive success. Sensitivity to disturbance and neophobia were repeatable, and thus represent personality traits. Moreover, females occupying territories near roads and pathways had shorter return latencies during novel object but not baseline trials, suggesting a specific reduction in neophobia in disturbed areas. Plasticity in neophobia also increased with disturbance level. In contrast, metal exposure did not affect neophobia or sensitivity to disturbance, despite negatively correlating with exploration behavior. Neophobia correlated with exploration behavior, but not aggression or reproductive success. Results suggest that shifts in personality types in urbanized areas might involve specific reductions in neophobia, rather than general reductions in sensitivity to disturbance, and unexpectedly indicate no effect of toxic metals on risk sensitivity.
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Affiliation(s)
- Andrea S Grunst
- Department of Biology, Behavioural Ecology and Ecophysiology Group, University of Antwerp, 2610 Wilrijk, Belgium.
| | - Melissa L Grunst
- Department of Biology, Behavioural Ecology and Ecophysiology Group, University of Antwerp, 2610 Wilrijk, Belgium
| | - Rianne Pinxten
- Department of Biology, Behavioural Ecology and Ecophysiology Group, University of Antwerp, 2610 Wilrijk, Belgium; Faculty of Social Sciences, Antwerp School of Education, University of Antwerp, 2000 Antwerp, Belgium
| | - Marcel Eens
- Department of Biology, Behavioural Ecology and Ecophysiology Group, University of Antwerp, 2610 Wilrijk, Belgium
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Shea TB, Remington R. Cognitive Improvement in Healthy Older Adults Can Parallel That of Younger Adults Following Lifestyle Modification: Support for Cognitive Reserve During Aging. J Alzheimers Dis Rep 2018; 2:201-205. [PMID: 30480262 PMCID: PMC6218155 DOI: 10.3233/adr-180056] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Executive function was assayed following a nutritional supplementation in healthy adults using the Trail Making Test. Comparison with published normative scores demonstrated that cohorts from 35-74 years of age displayed similar relative improvement compared to their own baseline performance. These findings support early, pro-active lifestyle modifications to maintain cognitive performance during aging and further demonstrate the persistence of cognitive reserve in healthy older adults.
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Affiliation(s)
- Thomas B Shea
- Department of Biological Sciences, UMass Lowell, Lowell, MA, USA
| | - Ruth Remington
- Department of Nursing, Framingham State University, Framingham, MA, USA
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White matter correlates of temporal discounting in older adults. Brain Struct Funct 2018; 223:3653-3663. [PMID: 29992469 DOI: 10.1007/s00429-018-1712-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 07/04/2018] [Indexed: 10/28/2022]
Abstract
Temporal discounting, the tendency to select a smaller reward offered sooner over a larger reward offered at a later time, has been associated with a number of real-world decision-making outcomes important for health and wellbeing. Neurobiological mechanisms supporting temporal discounting have been explored among younger participants, and these have considered white matter integrity. However, the white matter correlates of temporal discounting in older adults are unclear. We hypothesized that greater temporal discounting would be associated with poorer white matter integrity measures, more specifically lower fractional anisotropy and higher trace, in older adults. Participants were 302 older persons without dementia (mean age = 81.38, mean years of education = 15.75, 75.5% female, mean MMSE = 28.29) from the Rush Memory and Aging Project, a community-based longitudinal study of aging. Temporal discounting was assessed using standard elicitation questions. White matter integrity was assessed with diffusion tensor imaging (DTI). Regression models were adjusted for the effects of age, sex, education, and white matter lesions. Secondary models further adjusted for global cognition. Results revealed significant associations between temporal discounting and white matter integrity measures (FA and trace) in bilateral frontal, frontostriatal, and temporal-parietal lobe white matter tracts, and results remained significant after further accounting for global cognition. These results suggest that temporal discounting is inversely associated with white matter integrity in old age and that this association is independent of global cognition.
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McGill B, O'Hara BJ, Grunseit AC, Bauman A, Osborne D, Lawler L, Phongsavan P. Acceptability of financial incentives for maintenance of weight loss in mid-older adults: a mixed methods study. BMC Public Health 2018; 18:244. [PMID: 29439689 PMCID: PMC5811982 DOI: 10.1186/s12889-018-5136-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 02/01/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health insurers worldwide implement financial incentive schemes to encourage health-related behaviours, including to facilitate weight loss. The maintenance of weight loss is a public health challenge, and as non-communicable diseases become more prevalent with increasing age, mid-older adults could benefit from programs which motivate weight loss maintenance. However, little is understood about their perceptions of using financial incentives to maintain weight loss. METHODS We used mixed methods to explore the attitudes and views of participants who had completed an Australian weight loss and lifestyle modification program offered to overweight and obese health insurance members with weight-related chronic diseases, about the acceptability and usefulness of different types of financial incentives to support weight loss maintenance. An online survey was completed by 130 respondents (mean age = 64 years); and a further 28 participants (mean age = 65 years) attended six focus groups. RESULTS Both independent samples of participants supported a formalised maintenance program. Online survey respondents reported that non-cash (85.2%) and cash (77%) incentives would be potentially motivating; but only 40.5% reported that deposit contracts would motivate weight loss maintenance. Results of in-depth discussions found overall low support for any type of financial incentive, but particularly deposit contracts and lotteries. Some participants expressed that improved health was of more value than a monetary incentive and that they felt personally responsible for their own health, which was at odds with the idea of financial incentives. Others suggested ongoing program and peer support as potentially useful for weight loss maintenance. CONCLUSIONS If financial incentives are considered for mid-older Australian adults in the health insurance setting, program planners will need to balance the discordance between participant beliefs about the individual responsibility for health and their desire for external supports to motivate and sustain weight loss maintenance.
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Affiliation(s)
- Bronwyn McGill
- Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia. .,Charles Perkins Centre, John Hopkins Drive, University of Sydney, Sydney, NSW, 2006, Australia. .,The Australian Prevention Partnership Centre, Ultimo, NSW, 2007, Australia.
| | - Blythe J O'Hara
- Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia.,Charles Perkins Centre, John Hopkins Drive, University of Sydney, Sydney, NSW, 2006, Australia
| | - Anne C Grunseit
- Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia.,Charles Perkins Centre, John Hopkins Drive, University of Sydney, Sydney, NSW, 2006, Australia.,The Australian Prevention Partnership Centre, Ultimo, NSW, 2007, Australia
| | - Adrian Bauman
- Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia.,Charles Perkins Centre, John Hopkins Drive, University of Sydney, Sydney, NSW, 2006, Australia.,The Australian Prevention Partnership Centre, Ultimo, NSW, 2007, Australia
| | - Dale Osborne
- Osborne Research Services, Rozelle, NSW, 2039, Australia
| | - Luke Lawler
- Prima Health Solutions, PO Box 7468, Warringah Mall, NSW, 2100, Australia
| | - Philayrath Phongsavan
- Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia.,Charles Perkins Centre, John Hopkins Drive, University of Sydney, Sydney, NSW, 2006, Australia
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Bennett DA, Buchman AS, Boyle PA, Barnes LL, Wilson RS, Schneider JA. Religious Orders Study and Rush Memory and Aging Project. J Alzheimers Dis 2018; 64:S161-S189. [PMID: 29865057 PMCID: PMC6380522 DOI: 10.3233/jad-179939] [Citation(s) in RCA: 650] [Impact Index Per Article: 108.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The Religious Orders Study and Rush Memory and Aging Project are both ongoing longitudinal clinical-pathologic cohort studies of aging and Alzheimer's disease (AD). OBJECTIVES To summarize progress over the past five years and its implications for understanding neurodegenerative diseases. METHODS Participants in both studies are older adults who enroll without dementia and agree to detailed longitudinal clinical evaluations and organ donation. The last review summarized findings through the end of 2011. Here we summarize progress and study findings over the past five years and discuss new directions for how these studies can inform on aging and AD in the future. RESULTS We summarize 1) findings on the relation of neurobiology to clinical AD; 2) neurobiologic pathways linking risk factors to clinical AD; 3) non-cognitive AD phenotypes including motor function and decision making; 4) the development of a novel drug discovery platform. CONCLUSION Complexity at multiple levels needs to be understood and overcome to develop effective treatments and preventions for cognitive decline and AD dementia.
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Affiliation(s)
- David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL., USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL., USA
| | - Aron S. Buchman
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL., USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL., USA
| | - Patricia A. Boyle
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL., USA
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL., USA
| | - Lisa L. Barnes
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL., USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL., USA
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL., USA
| | - Robert S. Wilson
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL., USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL., USA
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL., USA
| | - Julie A Schneider
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL., USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL., USA
- Department of Pathology (Neuropathology), Rush University Medical Center, Chicago, IL., USA
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Thoma MV, Maercker A, Forstmeier S. Evidence for Different Trajectories of Delay Discounting in Older Adults With Mild Cognitive Impairment and Mild Alzheimer's Disease. J Gerontol B Psychol Sci Soc Sci 2017; 72:956-965. [PMID: 26896423 DOI: 10.1093/geronb/gbw010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 01/24/2016] [Indexed: 11/13/2022] Open
Abstract
Objectives To examine whether delay discounting (DD) develops differently within individuals diagnosed with mild cognitive impairment (MCI) or mild Alzheimer's disease (AD). Method We set out to study trajectories of DD in N = 111 older adults (Mage = 75.2 years, range: 55-94, 53% female) with MCI (n = 64) or mild AD (n = 47). Data were repeatedly assessed on three measurement times over a period of 2 years. Results Results indicated a meaningful difference in the trajectories of DD between MCI and mild AD (t = 2.99, p = .004), with AD patients displaying higher DD rates compared with MCI. Lower intelligence (t = -2.50, p = .013) was related to higher DD. We also found reward-dependent group differences in DD (small: p = .079; medium: p = .258; large: p = .007). Age, functional ability, general cognitive ability, living situation, and marital status were not meaningfully linked to DD (all non significant). Further explorative analyses revealed an increase in DD in patients whose cognitive symptoms had progressed at time 2, compared with more stable courses of mild AD or MCI (diagnosed at time 2). Discussion Our results point toward an increase in DD as a function of advanced cognitive decline.
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Affiliation(s)
- Myriam V Thoma
- Department of Psychopathology and Clinical Intervention.,University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Switzerland
| | - Andreas Maercker
- Department of Psychopathology and Clinical Intervention.,University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Switzerland
| | - Simon Forstmeier
- Department of Psychopathology and Clinical Intervention.,Department of Developmental Psychology, University of Siegen, Germany
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Mørkbak MR, Gyrd-Hansen D, Kjær T. Can present biasedness explain early onset of diabetes and subsequent disease progression? Exploring causal inference by linking survey and register data. Soc Sci Med 2017; 186:34-42. [DOI: 10.1016/j.socscimed.2017.05.050] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 05/18/2017] [Accepted: 05/25/2017] [Indexed: 10/19/2022]
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Yu L, Wilson RS, Han SD, Leurgans S, Bennett DA, Boyle PA. Decline in Literacy and Incident AD Dementia Among Community-Dwelling Older Persons. J Aging Health 2017. [PMID: 28645223 DOI: 10.1177/0898264317716361] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To quantify longitudinal change in financial and health literacy and examine the associations of declining literacy with incident Alzheimer's disease (AD) dementia and mild cognitive impairment (MCI). METHOD Data came from 799 participants of an ongoing cohort study. Literacy was measured using a battery of 32 questions. Clinical diagnoses were made annually following uniform structured procedures. The associations of declining literacy with incident AD dementia and MCI were tested using a joint model for longitudinal and time-to-event data. RESULTS We observed an overall decline in total literacy score over up to 6 years of follow-up ( p < .001). Faster decline in literacy was associated with higher risks for incident AD dementia (hazard ratio = 4.526, 95% confidence interval = [2.993, 6.843], p < .001) and incident MCI (hazard ratio = 2.971, 95% confidence interval = [1.509, 5.849], p = .002). DISCUSSION Declining literacy among community-dwelling older persons predicts adverse cognitive outcomes and serves as an early indicator of impending dementia.
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Affiliation(s)
- Lei Yu
- 1 Rush University Medical Center, Chicago, IL, USA
| | | | - S Duke Han
- 1 Rush University Medical Center, Chicago, IL, USA.,2 University of Southern California, Los Angeles, CA, USA
| | - Sue Leurgans
- 1 Rush University Medical Center, Chicago, IL, USA
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Sasse LK, Peters J, Brassen S. Cognitive Control Modulates Effects of Episodic Simulation on Delay Discounting in Aging. Front Aging Neurosci 2017; 9:58. [PMID: 28352226 PMCID: PMC5348631 DOI: 10.3389/fnagi.2017.00058] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 02/27/2017] [Indexed: 01/01/2023] Open
Abstract
Enhancing prospective thinking by tagging the future with specific episodic events has been shown to reduce delay discounting in young age (“tag-effect”). So far, it is unclear whether such beneficial effect extends to old adulthood. Since the general ability of future thinking and cognitive control are crucial modulators of temporal discounting in young age, potential age-related decline in these functions might impact on the effect. We focused on this issue by combining functional magnetic resonance imaging (fMRI) with an established intertemporal choice task including episodic “tags” in healthy older participants. Future thinking ability was assessed using autobiographical interviews for future event simulations and a visual search task was applied to assess participants’ cognitive control ability. In contrast to previous data in young adults, the group of older participants did not benefit from tagging the future with episodic events. Older participants’ cognitive control function was directly associated with discounting rates in the episodic conditions: the less the older adults were able to focus their attention the less they benefited from the inclusion of episodic events. Consistent with this, imaging results revealed that: (a) subjective value (SV) signals in the hippocampus and the anterior cingulate cortex (ACC) as well as; (b) hippocampal-striatal coupling during the episodic condition were positively related to participants’ control capacity. Our findings highlight the critical role of executive functioning for the simultaneous integration of episodic information with future value computation in aging. Boosting delay gratification by including episodic tags might hence be limited in older individuals with pronounced decline in distraction control.
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Affiliation(s)
- Laura K Sasse
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf Hamburg, Germany
| | - Jan Peters
- Department of Systems Neuroscience, University Medical Center Hamburg-EppendorfHamburg, Germany; Department of Psychology, University of CologneCologne, Germany
| | - Stefanie Brassen
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf Hamburg, Germany
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Abstract
After participating in this activity, learners should be better able to:• Assess the neuropsychological literature on decision making and the medical and legal assessment of capacity in patients with dementia• Identify the limitations of integrating findings from decision-making research into capacity assessments for patients with dementia ABSTRACT: Medical and legal professionals face the challenge of assessing capacity and competency to make medical, legal, and financial decisions in dementia patients with impaired decision making. While such assessments have classically focused on the capacity for complex reasoning and executive functions, research in decision making has revealed that motivational and metacognitive processes are also important. We first briefly review the neuropsychological literature on decision making and on the medical and legal assessment of capacity. Next, we discuss the limitations of integrating findings from decision-making research into capacity assessments, including the group-to-individual inference problem, the unclear role of neuroimaging in capacity assessments, and the lack of capacity measures that integrate important facets of decision making. Finally, we present several case examples where we attempt to demonstrate the potential benefits and important limitations of using decision-making research to aid in capacity determinations.
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Coelho S, Guerreiro M, Chester C, Silva D, Maroco J, Paglieri F, de Mendonça A. Delay discounting in mild cognitive impairment. J Clin Exp Neuropsychol 2016; 39:336-346. [DOI: 10.1080/13803395.2016.1226269] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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