Decision Making under Ambiguity and Objective Risk in Higher Age – A Review on Cognitive and Emotional Contributions

Liebherr, Magnus; Schiebener, Johannes; Averbeck, Heike; Brand, Matthias

doi:10.3389/fpsyg.2017.02128

Cited by 28 publications

(15 citation statements)

References 111 publications

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“…That was to be expected as previous research indicates that decision making under risk is less affected by normal aging than decisions under ambiguity (Zamarian, Sinz, Bonatti, Gamboz, & Delazer, 2008). Elderly controls' decision-making performance was consistently associated with executive functions, which is in accordance with studies on aging and decision making (for a review see Liebherr et al, 2017), whereby the mean decision-making performance was highest with decision support (t1). In contrast, mAD patients seemed to benefit more from decision support.…”

Section: Discussionsupporting

confidence: 86%

“…G. Morris & Kopelman, 1986;Perry, Watson, & Hodges, 2000;Welsh, Butters, Hughes, Mohs, & Heyman, 1992), even in the early stages of the disease. Changes in executive functions and other cognitive skills such as cognitive flexibility, inhibition, and working memory appear to account not only for disease-related but also for general age-related reductions in the decisionmaking performance under objective risk conditions Liebherr, Schiebener, Averbeck, & Brand, 2017;.…”

Section: Decision Making Under Risk In Neurocognitive Diseasesmentioning

confidence: 99%

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Decision support in patients with mild Alzheimer’s disease

Mueller

Arías

Vázquez³

et al. 2019

Journal of Clinical and Experimental Neuropsychology

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Introduction: Making advantageous decisions is a key competence of individuals of all ages. However, previous studies reported a reduction of this competence in patients with neurodegenerative diseases such as Alzheimer's disease, which is explained by impairments of executive functions such as cognitive flexibility or working memory. While previous findings from healthy participants with reduced executive functions showed that support can improve decision making under risk, the study at hand aimed to investigate this effect in patients with mild Alzheimer's disease (mAD). Method: A group of elderly individuals diagnosed with mAD (n = 14; mean MMSE = 24.14, SD = 3.18) and a control group of healthy age-matched controls (n = 14; mean MMSE = 29.29, SD = 1.98) performed a decision-making task (GDT) three times (t0, t1, t2) with intervals of five to nine days between each: The standard GDT plus other neurocognitive tasks (t0), the GDT with supportive information following each decision (t1), and again the GDT without decision support (t2). Results: At any time, mAD patients made more disadvantageous decisions than controls. However, the decision-making performance of mAD patients improved significantly with decision support. Interestingly, when the standard GDT was played again (t2), mAD patients' performance remained similar to the performance in the GDT with decision support (t1). GDT performance correlated consistently with executive function measures in the control group, but only at t0 in the mAD group. Conclusions: The findings indicate that supportive information about the riskiness of options can compensate for mAD-related deficits in decision making under risk. Thus, decision support can improve the quality of mAD patients' decisions. Further, it may prevent mAD patients from making highly risky decisions in similar situations in the future. The persistence of decision support should be further investigated as it has relevant implications for everyday decisions that include risks.

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Section: Discussionsupporting

confidence: 86%

Section: Decision Making Under Risk In Neurocognitive Diseasesmentioning

confidence: 99%

Decision support in patients with mild Alzheimer’s disease

Mueller

Arías

Vázquez³

et al. 2019

Journal of Clinical and Experimental Neuropsychology

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“…This is probably the most important limitation of our review, which prevented us from doing a metaanalysis, according to the PRISMA guidelines. Among these studies, there are several monetary models representing changes of perception with age, and their impact on decision-making is different from that of social or medical models [69]. Thus, our review reveals a variation in decision-making models according to what is taken into account: motivation or risk, and specificities related to the areas of daily life affected by these decisions (money, health, social) [53].…”

Section: Discussionmentioning

confidence: 97%

“…However, when decisions involve new situations, the arguments presented will be essential. However, given that sensitivity to loss prevention increases, and attractiveness of earnings decrease as we age, it is likely that the presentation of an earningbased motivation formula might not be as effective as the choice of the appropriate interlocutor [69].…”

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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“…Aging is associated with changes in multiple domains of cognitive functions, including inhibitory control. The ability to suppress an undesired action diminishes in the elderly especially in situations that involve uncertainty and conflicts (Liebherr, et al, 2017). Deficits in inhibitory control contribute to impaired daily function not only in individuals with mild cognitive impairment and dementia (O’Callaghan, et al, 2013) but also during healthy aging (Levin, et al, 2014; Lustig and Jantz, 2015).…”

Section: Introductionmentioning

confidence: 99%

Structural and functional cerebral bases of diminished inhibitory control during healthy aging

Ide

Chao

et al. 2018

Human Brain Mapping

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Inhibitory control or the ability to refrain from incorrect responses is a critical executive function known to diminish during aging. Imaging studies have elucidated cerebral changes that may underlie the age-related deficits. However, it remains unclear whether the structural and functional changes occur in the same brain regions and whether reduced gray matter volumes (GMV) mediate decreased activation during inhibition. Here, in a sample of 149 participants, we addressed the issues using structural and functional magnetic resonance imaging. Individual's response inhibition was evaluated by the stop signal reaction time (SSRT) in a stop signal task. The results showed that age was associated with prolonged SSRT across participants. Many cortical and subcortical regions demonstrated age-related reduction in GMV and activation to response inhibition. Additionally, age-related diminution in inhibitory control, as indexed by the SSRT, was associated with both shared and distinct morphometric and functional changes. Voxel-based morphometry demonstrated age-related reduction in GMV in the right dorsolateral prefrontal cortex and caudate head as well as bilateral insula, in association with prolonged SSRT. In a contrast of stop success versus go success trials, age was associated with lower activation in the medial and inferior frontal cortex and inferior parietal cortex. Further, reduction in GMV mediated age-related differences in activations only of the medial prefrontal cortex, providing limited evidence for structure function association. Thus, the decline in inhibitory control, as evidenced in the stop signal task, manifest with both shared and distinct structural and functional processes during aging.

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Decision Making under Ambiguity and Objective Risk in Higher Age – A Review on Cognitive and Emotional Contributions

Cited by 28 publications

References 111 publications

Decision support in patients with mild Alzheimer’s disease

Decision support in patients with mild Alzheimer’s disease

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

Structural and functional cerebral bases of diminished inhibitory control during healthy aging

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