Cognitive Mechanisms in Decision-Making in Patients With Mild Alzheimer Disease

Bailén, José Ramón Alameda; Salguero-Alcañiz, María Pilar; Clavellino, Ana Merchán; Paíno-Quesada, Susana

doi:10.2174/1567205014666170417113834

Cited by 13 publications

(10 citation statements)

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“…The number of his disadvantageous choices on deck A and B surpassed his advantageous choice on deck C and D close to 2.5-fold. This result further supports that he has risky behavior in decision making [ 13 14 ].…”

Section: Case Reportssupporting

confidence: 70%

The Impact of Compulsivity and Impulsivity in Cerebellar Ataxia: A Case Series

Amokrane

Lin

Desai

et al. 2020

Tremor and Other Hyperkinetic Movements

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Background: The cerebellum has recently been identified to have a key role in reward processing, and individuals with ataxia have been found to be more impulsive and compulsive as part of cerebellum-related cognitive and behavioral disturbances. Case Report: We reported five individuals with cerebellar ataxia who demonstrate impulsive and compulsive behaviors, including hobbyism, gambling, and compulsive medication use, to illustrate that these symptoms can be highly disabling. Discussion: These five cases provide examples of behavioral symptoms in cerebellar ataxia. Further investigations of the pathomechanism of these symptoms will advance our understanding of the cerebellum in cognition and behavior.

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Section: Case Reportssupporting

confidence: 70%

The Impact of Compulsivity and Impulsivity in Cerebellar Ataxia: A Case Series

Amokrane

Lin

Desai

et al. 2020

Tremor and Other Hyperkinetic Movements

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“…This finding suggests that the healthy controls assessed the advantageous decks more favorably than the disadvantageous decks and learned to decide advantageously by utilizing feedback and modifying their strategy over time, but the patients with AD and MCI did not. The response patterns of the two groups of clinical patients may be attributed to deficits in memory and executive function, which prevents them from establishing new stimulus-reward relationships and eliminating previously learned responses due to the parietal and temporal atrophy they present (44). Another possible explanation of these results is a dysfunctional ventromedial prefrontal cortex (VMPC) in patients with AD (45)(46)(47) and MCI (48).…”

Section: Discussionmentioning

confidence: 99%

Decision-Making Under Ambiguity or Risk in Individuals With Alzheimer’s Disease and Mild Cognitive Impairment

et al. 2020

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Background: Making advantageous decisions is essential in everyday life. Our objective was to assess how patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD) make decisions under conditions of ambiguity or risk. In addition, the study also aimed to examine the relationship between decision-making competence and memory and executive function.Methods: Patients with MCI (n = 36) and AD (n = 29) and healthy elderly controls (HC, n = 34) were recruited from the memory clinic. All subjects were administered a comprehensive neuropsychological battery test. We used the Iowa Gambling Task (IGT) to measure decisionmaking under ambiguity and the Game of Dice Task (GDT) to measure decision-making under risk. Pearson's correlation was used to examine the relationship between the performance of IGT and GDT with delayed recall and the Stroop test.Results: In the GDT, MCI and AD patients presented similar performance but showed different patterns when compared with the HC group. The proportion of those making advantageous choices was lower in the AD group than in the HC group (p = 0.01), while the MCI and HC groups did not differ (p = 0.14). Meanwhile, concerning the ratio of accepting negative feedback, the AD (p < 0.01) group was significantly different from the HC patients, but the MCI (p = 0.06) and HC groups did not differ. In the IGT, MCI and AD patients selected randomly from advantageous and disadvantageous decks (p = 0.94 and p = 0.54), showing no significant change in performance over time. In contrast, the HC group made increasingly frequent advantageous selections over time (p = 0.04). Furthermore, the proportion of advantageous decision-makers for the GDT had a linear relationship with delayed recall of the Hopkins Verbal Learning Test and Stroop color words (p < 0.01 and p < 0.01, respectively). Conclusion:Our findings suggest that decision-making ability under ambiguity is compromised in MCI and AD, and the decision-making under risk is only impaired in AD. Reduced decision-making performance under risk is closely correlated with lower executive functions and memory.

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“…This should have been made prospectively to be sure that they did not present, at the time of their inclusion, a neurocognitive pathology at an infra-clinical stage. Indeed, neurodegenerative pathologies impact decision-making capacities [62][63][64][65]. Nevertheless, it appears that tests focused on decision-making processes can remain informative even in the mild stages of these diseases, and the impact of mild pathological cases on overall results is limited, as shown in Jacus et al [66].…”

Section: Discussionmentioning

confidence: 99%

How does decisional capacity evolve with normal cognitive aging: systematic review of the literature

et al. 2019

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Key summary pointsAim The complexity of decision-making involves many neurological functions and structures which are potentially altered by cognitive aging. Findings Our systematic review shows a decrease in processing speed in normal aging, usually compensated by experience. Nevertheless, in the case of decisions that cannot be based on previous experience, decision-making will be more difficult for older adults. Compared to younger adults, older ones will be more inclined to maintain existing achievements than try to gain potential benefits.Message Decision-making supports should take into account age-related characteristics to facilitate informed decision-making. AbstractPurpose Aging is associated with increased needs related to complex decisions, particularly in medical and social issues. However, the complexity of decision-making involves many neurological functions and structures which are potentially altered by cognitive aging. Methodology A systematic review was conducted in accordance with PRISMA guidelines to examine changes in decisionmaking occurring in normal cognitive aging. The keywords "decision making" and "normal aging" were used to find the clinical studies and literature reviews focused on these changes. Results A total of 97 articles were considered in the review, and ultimately 40 articles were selected, including 30 studies and 10 literature reviews. The data from these studies were of uneven quality and too disparate to allow meta-analysis according to PRISMA criteria. Nevertheless, a key result of the analysis is the decrease of processing speed with aging. In ambiguous decision-making situations, the alteration of the ventromedial system is associated with changes in motivation profiles. These changes can be compensated by experience. However, difficulties arise for older adults in the case of one-off decisions, which are very common in the medical or medico-social domains. Conclusions Cognitive aging is associated with a slowdown in processing speed of decision-making, especially in ambiguous situations. However, decision-making processes which are based on experience and cases in which sufficient time is available are less affected by aging. These results highlight the relativity of decision-making capacities in cognitive aging.

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Cognitive Mechanisms in Decision-Making in Patients With Mild Alzheimer Disease

Cited by 13 publications

References 0 publications

The Impact of Compulsivity and Impulsivity in Cerebellar Ataxia: A Case Series

The Impact of Compulsivity and Impulsivity in Cerebellar Ataxia: A Case Series

Decision-Making Under Ambiguity or Risk in Individuals With Alzheimer’s Disease and Mild Cognitive Impairment

How does decisional capacity evolve with normal cognitive aging: systematic review of the literature

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