School of Psychology, University of New South Wales, Sydney, Australia.
Australian Research Council Centre of Excellence in Population Ageing Research, University of New South Wales, Sydney, Australia.
J Int Neuropsychol Soc. 2023 Jul;29(6):594-604. doi: 10.1017/S1355617722000765. Epub 2022 Nov 3.
Previous research has indicated that cognition and executive function are associated with decision-making, however the impact of mild cognitive impairment (MCI) on decision-making under explicit risk conditions is unclear. This cross-sectional study examined the impact of MCI, and MCI subtypes, on decision-making on the Game of Dice Task (GDT), among a cohort of older adults.
Data from 245 older adult participants (aged 72-78 years) from the fourth assessment of the Personality and Total Health Through Life study were analyzed. A diagnostic algorithm identified 103 participants with MCI, with subtypes of single-domain amnestic MCI (aMCI-single; = 38), multi-domain amnestic MCI (aMCI-multi; = 31), and non-amnestic MCI ( = 33), who were compared with an age-, sex-, education-, and income-matched sample of 142 cognitively unimpaired older adults. Decision-making scores on the GDT (net score, single number choices, and strategy changes) were compared between groups using nonparametric tests.
Participants with MCI showed impaired performance on the GDT, with higher frequencies of single number choices and strategy changes. Analyses comparing MCI subtypes indicated that the aMCI-multi subtype showed increased frequency of single number choices compared to cognitively unimpaired participants. Across the sample of participants, decision-making scores were associated with measures of executive function (cognitive flexibility and set shifting).
MCI is associated with impaired decision-making performance under explicit risk conditions. Participants with impairments in multiple domains of cognition showed the clearest impairments. The GDT may have utility in discriminating between MCI subtypes.
先前的研究表明，认知和执行功能与决策有关，但轻度认知障碍（MCI）对明确风险条件下决策的影响尚不清楚。本横断面研究考察了 MCI 及其亚型对人格与生命全程健康研究第四轮评估中一组老年受试者在骰子游戏任务（GDT）中决策的影响。
分析了人格与生命全程健康研究第四轮评估中 245 名年龄在 72-78 岁的老年受试者的数据。使用诊断算法确定了 103 名 MCI 受试者，其中包括单域遗忘型 MCI（aMCI-single；n=38）、多域遗忘型 MCI（aMCI-multi；n=31）和非遗忘型 MCI（n=33），并将他们与 142 名认知正常的年龄、性别、教育和收入匹配的老年对照组进行比较。使用非参数检验比较 GDT 的决策得分（净得分、单次选择和策略变化）在组间的差异。
MCI 组在 GDT 上的表现受损，单次选择和策略变化的频率更高。对 MCI 亚型的分析表明，与认知正常的参与者相比，aMCI-multi 亚型的单次选择频率更高。在整个受试者样本中，决策得分与执行功能（认知灵活性和定势转换）的测量结果相关。
MCI 与明确风险条件下的决策表现受损有关。认知多个领域受损的受试者表现出最明显的受损。GDT 可能有助于区分 MCI 亚型。
