Gaubert Fanny, Borg Céline, Chainay Hanna
Etude des Mécanismes Cognitifs Laboratory, Lyon 2 University, Bron, France.
University Hospital of Saint-Etienne, Hôpital Nord, Saint-Etienne, France.
J Alzheimers Dis. 2022;90(4):1793-1815. doi: 10.3233/JAD-220581.
Alzheimer's disease (AD) negatively impacts patients' ability to make advantageous decisions, i.e., a core ability contributing to the preservation of autonomy.
The present study aims to analyze the changes that occur in the decision-making competence (DMC) in AD patients and to determine if these changes are related to the deterioration of executive functions and working memory.
To this end, 20 patients with AD and 20 elderly control adults were assessed using executive, working memory, and DMC tasks. The latter comprised the Iowa Gambling Task (IGT) and a scenarios task based on situations inspired by everyday life and performed under conditions of risk and ambiguity.
Results revealed lower performances in AD patients than in elderly control adults for all the tasks assessing cognitive functions. The AD patients also made more strategy changes during the IGT. In the scenarios tasks, the two groups took as many ambiguous or risky decisions, but AD patients tended to take more risks in the context of gain than elderly control adults did. Switching and updating ability, as well as working memory, appeared to be involved in decisions in tasks inspired by everyday life, while inhibition was more related to the IGT performances.
Working memory and executive functions seem to be involved in decision-making, but in different ways in gambling and daily-life situations.
阿尔茨海默病（AD）对患者做出有利决策的能力产生负面影响，而做出有利决策是维护自主性的一项核心能力。
本研究旨在分析AD患者决策能力（DMC）的变化，并确定这些变化是否与执行功能和工作记忆的衰退有关。
为此，使用执行、工作记忆和DMC任务对20例AD患者和20名老年对照成年人进行评估。后者包括爱荷华赌博任务（IGT）和一项基于受日常生活启发的情境且在风险和模糊条件下执行的情景任务。
在所有评估认知功能的任务中，AD患者的表现均低于老年对照成年人。AD患者在IGT期间也做出了更多的策略改变。在情景任务中，两组做出的模糊或风险决策数量相同，但AD患者在获益情境下比老年对照成年人更容易冒险。转换和更新能力以及工作记忆似乎参与了受日常生活启发的任务中的决策，而抑制作用与IGT表现的关系更为密切。
工作记忆和执行功能似乎参与了决策，但在赌博和日常生活情境中的方式不同。
