Discrepancies between cognition and decision making in older adults

被引:29
作者
Han, S. Duke [1 ,2 ,3 ,5 ]
Boyle, Patricia A. [2 ]
James, Bryan D. [1 ,2 ,3 ,4 ]
Yu, Lei [2 ,3 ]
Barnes, Lisa L. [1 ,2 ,3 ]
Bennett, David A. [2 ,3 ]
机构
[1] Rush Univ, Dept Behav Sci, Med Ctr, Chicago, IL 60612 USA
[2] Rush Univ, Med Ctr, Rush Alzheimers Dis Ctr, 600 S Paulina St,Suite 1022, Chicago, IL 60612 USA
[3] Rush Univ, Med Ctr, Dept Neurol Sci, Chicago, IL 60612 USA
[4] Rush Univ, Med Ctr, Dept Internal Med, Chicago, IL 60612 USA
[5] VA Long Beach Healthcare Syst, Mental Hlth Care Grp, Long Beach, CA USA
关键词
Decision making; Cognition; Discrepancy; FINANCIAL LITERACY; RISK-AVERSION; BRAIN; AGE; IMPULSIVITY; HEALTH;
D O I
10.1007/s40520-015-0375-7
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
There is increasing clinical and legal interest in discrepancies between decision-making ability and cognition in old age, a stage of life when decisions have major ramifications. We investigated the frequency and correlates of such discrepancies in non-demented older adults participating in a large community-based cohort study of aging, the Rush Memory and Aging Project. Participants [n = 689, mean age 81.8 (SD 7.6), mean education 15.2 (SD 3.1), 76.8 % female and 93.3 % white] completed a measure of financial and healthcare decision making (DM) and a battery of 19 neuropsychological tests from which a composite measure of global cognition (COG) was derived. Results indicated that 23.9 % of the sample showed a significant discrepancy between DM and COG abilities. Of these, 12.9 % showed DM < COG, while 11.0 % showed DM > COG. Logistic regression models showed older age, being non-white, greater temporal discounting, and greater risk aversion were associated with higher odds of being in the DM < COG group. Being male was associated with higher odds of being in the DM > COG group. Education, income, depressive symptoms, and impulsivity were not associated with a discrepancy. Only demographic associations (age, sex, and race) remained significant in a fully adjusted model with terms included for all factors. These results support the consideration of decision making and cognition as potentially separate constructs.
引用
收藏
页码:99 / 108
页数:10
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