a General Psychology: Cognition and Center for Behavioral Addiction Research (CeBAR) , University of Duisburg-Essen , Duisburg , Germany.
b Gabinete de Orientación Educativa , University Francisco de Vitoria , Madrid , Spain.
J Clin Exp Neuropsychol. 2019 Jul;41(5):484-496. doi: 10.1080/13803395.2019.1585517. Epub 2019 Mar 5.
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).
A group of elderly individuals diagnosed with mAD (n = 14; mean Mini-Mental State Examination, MMSE = 24.14, SD = 3.18) and a group of healthy age-matched controls (n = 14; mean MMSE = 29.29, SD = 1.98) performed the Game of Dice Task (GDT) three times (t, t t) with intervals of five to nine days between each: The standard GDT plus other neurocognitive tasks (t), the GDT with decision support (t), and again the standard GDT (t).
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 (t), mAD patients' performance remained similar to the performance in the GDT with decision support (t). GDT performance correlated consistently with executive function measures in the control group, but only at t in the mAD group.
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.
做出有利的决策是所有年龄段个体的关键能力。然而，先前的研究报告称，患有神经退行性疾病（如阿尔茨海默病）的患者的这种能力会下降，这可以通过执行功能（如认知灵活性或工作记忆）受损来解释。虽然先前对执行功能降低的健康参与者的研究表明，支持可以改善风险下的决策，但目前的研究旨在调查这种效应在轻度阿尔茨海默病（mAD）患者中是否存在。
一组被诊断为 mAD 的老年个体（n = 14；平均简易精神状态检查，MMSE = 24.14，SD = 3.18）和一组年龄匹配的健康对照组（n = 14；平均 MMSE = 29.29，SD = 1.98）三次完成骰子游戏任务（GDT）（t、t t），每次之间间隔五到九天：标准 GDT 加其他神经认知任务（t）、GDT 加决策支持（t）和再次进行标准 GDT（t）。
在任何时候，mAD 患者的不利决策都比对照组多。然而，mAD 患者的决策表现随着决策支持显著提高。有趣的是，当再次进行标准 GDT 时（t），mAD 患者的表现仍然与 GDT 加决策支持时相似（t）。GDT 表现与对照组的执行功能测量结果一致相关，但仅在 mAD 组的 t 时相关。
这些发现表明，关于选项风险的支持性信息可以补偿 mAD 患者在风险下的决策缺陷。因此，决策支持可以改善 mAD 患者的决策质量。此外，它可能防止 mAD 患者在未来类似情况下做出高风险决策。应该进一步研究决策支持的持久性，因为它对包含风险的日常决策具有重要意义。
