Age-Related Quantitative and Qualitative Changes in Decision Making Ability

Abstract

The “frontal aging hypothesis” predicts that brain senescence affects predominantly the prefrontal regions. Preliminary evidence has recently been gathered in favour of an age-related change in a typically frontal process, i.e. decision making, using the Iowa Gambling Task (IGT), but overall findings have been conflicting. Following the traditional scoring method, coupled with a qualitative analysis, in the present study we compared IGT performance of 40 young (mean age: 27.9 ± 4.7) and 40 old (mean age: 65.4 ± 8.6) healthy adults and of 18 patients affected by frontal lobe dementia of mild severity (mean age: 65.1 ± 7.4, mean MMSE score: 24.1 ± 3.9). Quantitative findings support the notion that decision making ability declines with age; moreover, it approximates the impairment observed in executive dysfunction due to neurodegeneration. Results of the qualitative analysis did not reach statistical significance for the motivational and learning decision making components considered, but approached significance for the attentional component for elderly versus young normals, suggesting a possible decrease in the ability to maintain sustained attention during complex and prolonged tasks as the putative deficit underlying impaired decision making in normal aging.

A Revision of the Relationship between Gambling Disorder, Attention Deficit Hyperactivity Disorder and Parkinson´s Disease

“…On the other hand, a work by Isella's research group proposed that the relationship between pd and gambling disorder could be explained by the effect of aging processes in some cognitive functions (including executive functioning); subsequently this disruption of cognitive functioning could induce risky and gambling behaviors (Isella et al, 2008). This study contrasted Iowa Gambling Test performances of 40 young, 40 old healthy adults, and 18 subjects affected by mild gravity dementia of the frontal lobe.…”

“…Moreover, it was found that decision-making skill deteriorated with age; furthermore, this deterioration was very similar to the type found in conditions of executive impairment due to neurodegeneration. Besides, it proposed that potential deficits in focused attention during lengthy tasks could be the subjacent disrupted decision-related factor in natural aging (Isella et al, 2008).…”

“…On the other hand, deep brain stimulation (sub-thalamic nucleus) in advanced stage pd patients alters the judgment during "chasing losses" (Rogers et al, 2011). 2) The incidence of gambling disorder in pd patients can be partially explained by aging effects on cognitive processes, based on the works of Isella et al (2008) and Zamarian et al (2008). Specifically, the disruption of the decision processes (executive function) is underlined by the inability to sustain attention during complex tasks (Isella et al, 2008).…”

“…2) The incidence of gambling disorder in pd patients can be partially explained by aging effects on cognitive processes, based on the works of Isella et al (2008) and Zamarian et al (2008). Specifically, the disruption of the decision processes (executive function) is underlined by the inability to sustain attention during complex tasks (Isella et al, 2008). Moreover, the effect of aging on decision processes depends on the degree of ambiguity of the task.…”

“…Moreover, the effect of aging on decision processes depends on the degree of ambiguity of the task. Taking together the findings of Isella (Isella et al, 2008) and Zamarian (Zamarian et al, 2008) research groups, the next relationship can be stated: if the rules of win and lose, and the probability options are clear (unambiguous condition), the effects of aging are non significant. However, if the rules of win and lose, and the options of probabilities are not clear (should be grasped by trial and error or experience), then the effect of aging on decision process is more impairing.…”