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The impact of mild cognitive impairment on decision-making under explicit risk conditions: Evidence from the Personality and Total Health (PATH) Through Life longitudinal study

Published online by Cambridge University Press:  03 November 2022

Craig Sinclair Open the ORCID record for Craig Sinclair [Opens in a new window] ,
Ranmalee Eramudugolla ,
Nicolas Cherbuin ,
Moyra E. Mortby  and
Kaarin J. Anstey
Craig Sinclair*
Affiliation:
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 UNSW Ageing Futures Institute, University of New South Wales, Sydney, Australia Neuroscience Research Australia (NeuRA), Sydney, Australia
Ranmalee Eramudugolla
Affiliation:
School of Psychology, University of New South Wales, Sydney, Australia UNSW Ageing Futures Institute, University of New South Wales, Sydney, Australia
Nicolas Cherbuin
Affiliation:
Australian Research Council Centre of Excellence in Population Ageing Research, University of New South Wales, Sydney, Australia Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia
Moyra E. Mortby
Affiliation:
School of Psychology, University of New South Wales, Sydney, Australia UNSW Ageing Futures Institute, University of New South Wales, Sydney, Australia Neuroscience Research Australia (NeuRA), Sydney, Australia
Kaarin J. Anstey
Affiliation:
School of Psychology, University of New South Wales, Sydney, Australia UNSW Ageing Futures Institute, University of New South Wales, Sydney, Australia Neuroscience Research Australia (NeuRA), Sydney, Australia Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australia
*
Corresponding author: Craig Sinclair, email: c.sinclair@unsw.edu.au
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Abstract

Objective:

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.

Method:

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; n = 38), multi-domain amnestic MCI (aMCI-multi; n = 31), and non-amnestic MCI (n = 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.

Results:

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).

Conclusion:

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.

Keywords

decision-makingolder adultscognitive dysfunctionmild cognitive impairmentexecutive functionGame of Dice Task
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 29 , Issue 6 , July 2023 , pp. 594 - 604
Copyright
Copyright © INS. Published by Cambridge University Press, 2022

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