Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.
Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois, USA.
J Gerontol B Psychol Sci Soc Sci. 2023 Oct 9;78(10):1659-1667. doi: 10.1093/geronb/gbad037.
To test the hypotheses that decision making ability declines in old age and that a higher level of cognitive reserve is associated with a reduced rate of decline.
As part of an ongoing cohort study, 982 older adults without dementia at study enrollment completed measures of purpose in life and cognitive activity which were used as markers of cognitive reserve. At annual intervals thereafter, they completed 6 tests of decision making.
In a factor analysis of baseline decision making scores, 3 measures (financial/health literacy, financial/health decision making, scam susceptibility) loaded on an "analytic" factor and 3 (temporal discounting small stakes, temporal discounting large stakes, risk aversion) loaded on a "preferences" (for temporal discounting and avoiding risk) factor. During a mean of 4.7 years of follow-up (standard deviation = 2.9), analytic factor scores decreased (mean = 0.042-unit per year, standard error [SE] = 0.006, p < .001) and preferences factor scores increased (mean = 0.021-unit per year, SE = 0.006, p < .001), with a correlation of 0.13 (p < .001) between rates of change. Evidence of an association between cognitive reserve and decision making was mixed with purpose in life related to change in analytic decision making, whereas past (but not current) cognitive activity was related to change in decision making preferences.
Decision making analysis and preferences change over time in late life. Change over time in decision making components is relatively independent and differentially related to age and cognitive reserve.
检验以下两个假设，即决策能力随着年龄的增长而下降，以及较高的认知储备水平与下降速度较慢相关。
作为一项正在进行的队列研究的一部分，982 名在研究开始时没有痴呆的老年人完成了生活目标和认知活动的测量，这些测量被用作认知储备的标志物。此后，他们每年完成 6 项决策测试。
在基线决策得分的因子分析中，3 项措施（金融/健康素养、金融/健康决策、诈骗易感性）加载在一个“分析”因子上，3 项措施（小赌注时间折扣、大赌注时间折扣、风险规避）加载在一个“偏好”（时间折扣和规避风险）因子上。在平均 4.7 年的随访期间（标准差=2.9），分析因子得分下降（平均每年 0.042 个单位，标准误差[SE]=0.006，p<0.001），偏好因子得分增加（平均每年 0.021 个单位，SE=0.006，p<0.001），变化率之间的相关系数为 0.13（p<0.001）。认知储备与决策之间的关联证据存在差异，生活目标与分析决策的变化有关，而过去（而非当前）的认知活动与决策偏好的变化有关。
在晚年，决策分析和偏好会随着时间的推移而发生变化。决策组成部分随时间的变化相对独立，并且与年龄和认知储备有不同的关系。
