Review of Decision-Making in Game Tasks in Elderly Participants with Alzheimer Disease and Mild Cognitive Impairment

Siqueira, Adriano Felipe Perez; Yokomizo, Juliana Emy; Jacob‐Filho, Wilson; Yassuda, Mônica Sanches; Aprahamian, Ivan

doi:10.1159/000455120

Cited by 25 publications

(22 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The results showed that AD patients were at greater risk for unfavorable DM compared to healthy controls. However, MCI patients had similar difficulties in making advantageous decisions to the problems experienced by probable AD individuals but were less impaired on DM tasks (Siqueira et al, 2017). In the present study, having dementia was also associated with an unfavorable DM profile (i.e.…”

Section: Discussionsupporting

confidence: 47%

See 1 more Smart Citation

Decision-making profile in older adults: the influence of cognitive impairment, premorbid intelligence and depressive symptoms

Biella

Siqueira

Borges

et al. 2019

Int. Psychogeriatr.

Self Cite

View full text Add to dashboard Cite

ABSTRACTObjective:Decision-making (DM) is a component of executive functioning. DM is essential to make proper decisions regarding important life and health issues. DM can be impaired in cognitive disorders among older adults, but current literature is scarce. The aim of this study was to evaluate the DM profile in participants with and without cognitive impairment.Design:Cross-sectional analysis of a cohort study on cognitive aging.Participants:143 older adults.Setting:University-based memory clinic.Methods:Patients comprised three groups after inclusion and exclusion criteria: healthy controls (n=29), mild cognitive impairment (n=81) and dementia (n=33). Participants were evaluated using an extensive neuropsychological protocol. DM profile was evaluated by the Melbourne Decision Making Questionnaire. Multinomial logistic regression was used to evaluate associations between age, sex, educational level, estimated intelligence quotient (IQ), cognitive disorders, depressive or anxiety symptoms, and the DM profiles.Results:The most prevalent DM profile was the vigilant type, having a prevalence of 64.3%. The vigilant profile also predominated in all three groups. The multinomial logistic regression showed that the avoidance profile (i.e. buck-passing) was associated with a greater presence of dementia (p=0.046) and depressive symptoms (p=0.024), but with less anxious symptoms (p=0.047). The procrastination profile was also associated with depressive symptoms (p=0.048). Finally, the hypervigilant profile was associated with a lower pre-morbid IQ (p=0.007).Conclusion:Older adults with cognitive impairment tended to make more unfavorable choices and have a more dysfunctional DM profile compared to healthy elders.

show abstract

Section: Discussionsupporting

confidence: 47%

“…Independence is largely preserved in activities of daily living and older adults with MCI frequently need to make decisions. However, studies investigating DM in MCI patients remain scarce (Siqueira et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Decision-making profile in older adults: the influence of cognitive impairment, premorbid intelligence and depressive symptoms

Biella

Siqueira

Borges

et al. 2019

Int. Psychogeriatr.

Self Cite

View full text Add to dashboard Cite

show abstract

“…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

View full text Add to dashboard Cite

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.

show abstract

“…Patients suffering from neurodegenerative diseases such as AD show significant decision-making impairments in laboratory decision-making tasks (de Siqueira, Yokomizo, Jacob-Filho, Yassuda, & Aprahamian, 2017;Gleichgerrcht et al, 2010).…”

Section: Decision Making Under Risk In Neurocognitive Diseasesmentioning

confidence: 99%

“…Most of the studies summarized in a recent review by de Siqueira et al (2017) investigated patients in early stages of probable mAD and mild cognitive impairment showing decision-making deficits in situations under both ambiguity and risk. The Game of Dice Task (GDT; Brand et al, 2005) is one of the most frequently used tasks to measure decision-making under (objective) risk conditions.…”

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

View full text Add to dashboard Cite

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.

show abstract

Review of Decision-Making in Game Tasks in Elderly Participants with Alzheimer Disease and Mild Cognitive Impairment

Cited by 25 publications

References 21 publications

Decision-making profile in older adults: the influence of cognitive impairment, premorbid intelligence and depressive symptoms

Decision-making profile in older adults: the influence of cognitive impairment, premorbid intelligence and depressive symptoms

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

Decision support in patients with mild Alzheimer’s disease

Contact Info

Product

Resources

About