Decision-Making Support for People With Alzheimer’s Disease: A Narrative Review

Abstract

The proportion of people with dementia has been increasing yearly, and the decision-making capacity of these people has become a major concern in fields such as the financial industry and in medical settings. In this narrative review, we discuss decision-making in people with Alzheimer’s disease (AD), and we propose the support for decision-making in people with AD, especially financial and medical decision-making. We summarize several hypotheses and theories on the decision-making capacity of people with AD. These include the frontal lobe hypothesis, physiological theory, dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis, and the Person-Task-Fit (PTF) framework. Both internal and external factors can affect decision-making by people with AD. Internal factors are affected by changes in the brain and neurotransmitters, as well as alterations in cognitive ability and emotion. External factors include task characters, task contents, and situation influence. Since feedback has a significant effect on decision-making capacity, a series of suggestions may be helpful to improve this capacity, such as explicit advice, simple options, pleasant rewards, the Talking Mats approach, memory and organizational aid, support by caregivers, cognitive training and feedback. Thus, in providing decision-making support for people with AD, it is important to identify the internal and external factors that impair this process and to deal with these factors.

Combination therapy with platelet-rich plasma and epidermal neural crest stem cells increases treatment efficacy in vascular dementia

“…A decrease in grooming numbers without any recovery in central and peripheral time may not be a reliable indicator of animal stress and anxiety 53,54 . People with dementia have di culties performing a variety of decision-making in daily living 55 . Brain regions associated with decision-making are frontal, temporal, and parietal regions and these areas vulnerable to age-related change 56 .…”

Brain Neural Underpinnings of Interoception and Decision-Making in Alzheimer's Disease: A Narrative Review

“…To the best of our knowledge, this is the first review that attempts to analyze findings of previous studies on the causes of reduced decision-making ability in patients with AD from the perspective of interoception. While our previous study investigated the reasons for reduced decision-making ability in patients with AD (Sun et al, 2021 ), the role of interoception was not taken into account. By analyzing the theoretical background and brain neural underpinnings involved in interoception and decision-making, we found that these brain areas are often simultaneously affected by AD pathology.…”

“…We discussed the decrease in the decision-making ability of patients with AD in our previous article (Sun et al, 2021 ). We found their decision-making ability was influenced by both internal and external factors.…”

Mapping the Neural Basis of Neuroeconomics with Functional Magnetic Resonance Imaging: A Narrative Literature Review

“…Moreover, with the prevalence of neurodegenerative diseases such as Alzheimer's and Parkinson's on the rise, there is a pressing need to delve deeper into how these conditions intersect with decision-making abilities [62,63]. Exploring the neural mechanisms underlying decision making in individuals affected by such diseases can provide invaluable insights into their cognitive decline and potential interventions.…”