Department of Psychology, USC Dornsife College of Letters, Arts, and Sciences, Los Angeles, CA, USA.
Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.
J Alzheimers Dis. 2023;94(4):1607-1615. doi: 10.3233/JAD-230222.
Older adults are faced with many unique and highly consequential decisions such as those related to finances, healthcare, and everyday functioning (e.g., driving cessation). Given the significant impact of these decisions on independence, wellbeing, and safety, an understanding of how cognitive impairment may impact decision making in older age is important.
To examine the impact of mild cognitive impairment (MCI) on responses to a modified version of the Short Portable Assessment of Capacity for Everyday Decision making (SPACED).
Participants were community-dwelling, actively driving older adults (N = 301; M age = 77.1 years, SD = 5.1; 69.4% with a college degree or higher; 51.2% female; 95.3% White) enrolled in the Advancing Understanding of Transportation Options (AUTO) study. A generalized linear model adjusted for age, education, sex, randomization group, cognitive assessment method, and study site was used to examine the relationship between MCI status and decision making.
MCI status was associated with poorer decision making; participants with MCI missed an average of 2.17 times more points on the SPACED than those without MCI (adjusted mean ratio: 2.17, 95% CI: 1.02, 4.61, p = 0.044).
This finding supports the idea that older adults with MCI exhibit poorer decision-making abilities than cognitively normal older adults. It also suggests that older adults with MCI may exhibit poorer decision making across a wide range of decision contexts.
老年人面临着许多独特且极具影响力的决策，例如与财务、医疗保健和日常功能相关的决策（例如，停止驾驶）。鉴于这些决策对独立性、幸福感和安全的重大影响，了解认知障碍如何影响老年人的决策非常重要。
研究轻度认知障碍（MCI）对经过修改的日常决策能力简易评估测试（SPACED）的反应的影响。
参与者是居住在社区、仍在开车的老年人（N=301；平均年龄为 77.1 岁，标准差为 5.1；69.4%的人有大学学历或以上；51.2%为女性；95.3%为白人），他们参加了推进交通选择理解（AUTO）研究。使用广义线性模型，根据年龄、教育程度、性别、随机分组、认知评估方法和研究地点进行调整，以检验 MCI 状况与决策之间的关系。
MCI 状况与较差的决策能力有关；与没有 MCI 的参与者相比，MCI 患者在 SPACED 上平均错过 2.17 分（调整后的平均比值：2.17，95%置信区间：1.02，4.61，p=0.044）。
这一发现支持了这样一种观点，即患有 MCI 的老年人的决策能力比认知正常的老年人差。这也表明，患有 MCI 的老年人在广泛的决策情境中可能表现出较差的决策能力。
