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Aging and Decision Making -

Aging and Decision Making (eBook)

Empirical and Applied Perspectives
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2015 | 1. Auflage
432 Seiten
Elsevier Science (Verlag)
978-0-12-417155-8 (ISBN)
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Decisions large and small play a fundamental role in shaping life course trajectories of health and well-being: decisions draw upon an individual's capacity for self-regulation and self-control, their ability to keep long-term goals in mind, and their willingness to place appropriate value on their future well-being. Aging and Decision Making addresses the specific cognitive and affective processes that account for age-related changes in decision making, targeting interventions to compensate for vulnerabilities and leverage strengths in the aging individual. This book focuses on four dominant approaches that characterize the current state of decision-making science and aging - neuroscience, behavioral mechanisms, competence models, and applied perspectives. Underscoring that choice is a ubiquitous component of everyday functioning, Aging and Decision Making examines the implications of how we invest our limited social, temporal, psychological, financial, and physical resources, and lays essential groundwork for the design of decision supportive interventions for adaptive aging that take into account individual capacities and context variables. - Divided into four dominant approaches that characterize the current state of decision-making science and aging neuroscience - Explores the impact of aging on the linkages between cortical structures/functions and the behavioral indices of decision-making - Examines the themes associated with behavioral approaches that attempt integrations of methods, models, and theories of general decision-making with those derived from the study of aging - Details the changes in underlying competencies in later life and the two prevailing themes that have emerged-one, the general individual differences perspective, and two, a more clinical focus
Decisions large and small play a fundamental role in shaping life course trajectories of health and well-being: decisions draw upon an individual's capacity for self-regulation and self-control, their ability to keep long-term goals in mind, and their willingness to place appropriate value on their future well-being. Aging and Decision Making addresses the specific cognitive and affective processes that account for age-related changes in decision making, targeting interventions to compensate for vulnerabilities and leverage strengths in the aging individual. This book focuses on four dominant approaches that characterize the current state of decision-making science and aging - neuroscience, behavioral mechanisms, competence models, and applied perspectives. Underscoring that choice is a ubiquitous component of everyday functioning, Aging and Decision Making examines the implications of how we invest our limited social, temporal, psychological, financial, and physical resources, and lays essential groundwork for the design of decision supportive interventions for adaptive aging that take into account individual capacities and context variables. - Divided into four dominant approaches that characterize the current state of decision-making science and aging neuroscience- Explores the impact of aging on the linkages between cortical structures/functions and the behavioral indices of decision-making- Examines the themes associated with behavioral approaches that attempt integrations of methods, models, and theories of general decision-making with those derived from the study of aging- Details the changes in underlying competencies in later life and the two prevailing themes that have emerged one, the general individual differences perspective, and two, a more clinical focus

AGING ANDDECISIONMAKING 4
Copyright 5
Contents 6
Contributors 12
FOREWORD* 16
OPEN QUESTIONS 17
A RESEARCH AGENDA FOR THE FUTURE 19
CONCLUSION 21
References 22
Preface 26
Chapter 1 - The Present, Past, and Future of Research on Aging and Decision Making 30
BASIC ISSUES IN THE STUDY OF AGING AND DECISIONS 31
BOOK OVERVIEW 37
CONCLUSION 41
References 42
Chapter 2- Modeling Cost–Benefit Decision Making in Aged Rodents 46
INTRODUCTION 46
INDIVIDUAL DIFFERENCES AND COGNITIVE AGING 47
CROSS-SPECIES COMPARISONS OF NEURAL CIRCUITRY RELEVANT FOR DECISION MAKING 48
CROSS-SPECIES CONSIDERATIONS OF REINFORCERS 49
INTERTEMPORAL DECISION MAKING 50
PROBABILISTIC (RISKY) DECISION MAKING 57
THE ROLE OF AGE-RELATED MEMORY IMPAIRMENT IN DECISION MAKING 60
CONCLUSION 62
References 63
Chapter3 - Decision Neuroscience and Aging 70
OVERVIEW OF FRONTOSTRIATAL NEURAL CIRCUITRY 70
GAINS AND LOSSES 73
INTERTEMPORAL DECISION MAKING 74
RISKY DECISION MAKING 76
LEARNING 79
CONCLUSIONS 82
References 84
Chapter4 - Towards a Mechanistic Understanding of Age-Related Changes in Learning and Decision Making: A Neuro-Computational Approach 90
AGE-RELATED DECLINE IN THE DOPAMINE SYSTEM 91
AGE DIFFERENCES IN LEARNING FROM EXPERIENCE 94
CONCLUSIONS 100
References 103
Chapter5 - Age-Associated Executive Dysfunction, the Prefrontal Cortex, and Complex Decision Making 108
GUIDING OBSERVATIONS, THEORETICAL FRAMEWORKS, AND KEY EMPIRICAL TESTS 110
RESEARCH ON AGING 114
CONCLUSIONS AND IMPLICATIONS 125
References 127
Chapter6 - Adaptive Decision Making and Aging 134
AN ECOLOGICAL PERSPECTIVE ON LIFE-SPAN CHANGES IN STRATEGY USE 134
COGNITIVE AGING: THE ROLE OF COGNITIVE CONTROL AND REWARD PROCESSING 137
AGING AND STRATEGY USE 138
AGING AND STRATEGY USE IN DECISION MAKING 143
IMPLICATIONS OF AGE DIFFERENCES IN STRATEGY SELECTION AND EXECUTION 149
SUMMARY AND CONCLUSION 150
References 151
Chapter7 - Aging, Memory, and Decision Making 156
INTRODUCTION 156
AGE-RELATED CHANGES IN MEMORY FUNCTIONING AND THEIR INFLUENCE ON JUDGMENT AND DECISION MAKING 157
AGING, MEMORY, AND DECISION MAKING: WHERE DO WE GO FROM HERE? 170
References 171
Chapter8 - Complementary Contributions of Fluid and Crystallized Intelligence to Decision Making Across the Life Span 178
BETTER OR WORSE OFF? 178
COGNITIVE CAPABILITIES AND DECISION MAKING ACROSS THE ADULT LIFE SPAN 179
COMPLEMENTARY COGNITIVE CAPABILITIES 182
PRACTICAL DECISION MAKING AND THE ROLE OF DOMAIN-SPECIFIC EXPERIENCE 186
IMPLICATIONS FOR PUBLIC POLICY AND EFFECTIVE DECISION ENVIRONMENTS 190
SUMMARY 193
References 193
Chapter9 - Aging, Emotion, and Decision Making 198
AGE-RELATED CHANGES IN COGNITION, EMOTION, AND MOTIVATION 199
THEORETICAL PERSPECTIVES ON THE ROLE OF AFFECT IN JUDGMENT AND DECISION MAKING 201
DECISION MAKING ACROSS THE ADULT LIFE SPAN 207
CONCLUSIONS AND FUTURE RESEARCH DIRECTIONS 211
References 213
Chapter10 - A Prospect Theory-Based Evaluation of Dual-Process Influences on Aging and Decision Making: Support for a Contextual Perspective 218
DUAL-PROCESS PERSPECTIVES ON DECISION MAKING 219
DUAL-PROCESS INFLUENCES AND PROSPECT THEORY 221
CONCLUSIONS 235
References 238
Chapter11 - Age Differences in Time Perception and Their Implications for Decision Making Across the Life Span 242
AGE DIFFERENCES IN GLOBAL TIME HORIZONS AND MENTAL REPRESENTATIONS OF TIME 243
MECHANISMS 246
IMPLICATIONS FOR DECISION MAKING 249
FUTURE DIRECTIONS AND PRACTICAL IMPLICATIONS 254
References 256
Chapter12 - Understanding Life-Span Developmental Changes in Decision-Making Competence 264
OVERVIEW 264
DEFINING DECISION-MAKING COMPETENCE 265
DELIBERATION, AFFECT, AND DECISION-MAKING COMPETENCE 267
AGING AND DECISION-MAKING COMPETENCE 268
MOTIVATIONAL MODEL OF AGING AND DECISION-MAKING COMPETENCE 271
CURRENT CHALLENGES AND DIRECTIONS FOR FUTURE RESEARCH 275
SUMMARY AND CONCLUSIONS 280
References 281
Chapter13 - Decision Making and Health Literacy among Older Adults 290
INTRODUCTION 290
OLDER ADULTS AND HEALTH DECISIONS 291
AGING, HEALTH LITERACY, AND HEALTH-RELATED DECISIONS 297
CONCLUSIONS 305
References 307
Chapter14 - Decisions and Actions for Life Patterns and Health Practices as We Age: A Bottom-up Approach 312
OVERVIEW 312
THEMES FOR MODELING HEALTH PREFERENCES AND DECISIONS 313
MODELING THE PROCESSES UNDERLYING HEALTH DECISIONS AND ACTIONS 314
EXECUTIVE FUNCTION IN A COMMON-SENSE FRAMEWORK: SELECTIVE EVIDENCE 324
SUMMARY AND THOUGHTS FOR THE FUTURE 332
References 335
Chapter15 - Choice and Aging: Less is More 338
INTRODUCTION 338
CHOICE PREFERENCE AND SIZE IN DECISION MAKING 339
DUAL-PROCESS MODELS AND IMPLICATIONS FOR DECISION MAKING IN OLDER ADULTS 341
AN EMPIRICAL STUDY TESTING THE MEDIATING EFFECT OF COGNITIVE ABILITY ON CHOICE PREFERENCE 343
NUMERACY AND CHOICE SET SIZE IN DECISION MAKING 346
ADDITIONAL FACTORS IN RELATION TO CHOICE SET SIZE AND PREFERENCE 348
SUMMARY 350
References 353
Chapter16 - Financial Decision Making across the Adult Life Span: Dynamic Cognitive Capacities and Real-World Competence 358
FLUID ABILITIES, CRYSTALLIZED ABILITIES, AND FINANCIAL KNOWLEDGE 359
THE NATURE OF FINANCIAL DECISION-MAKING TASKS 361
REASONS WHY INDIVIDUALS MAKE POOR FINANCIAL DECISIONS 365
INTERVENTIONS DESIGNED TO IMPROVE FINANCIAL DECISION MAKING 371
SUMMARY AND CONCLUSION 373
References 374
Chapter17 - Aging and Consumer Decision Making 380
AGE DIFFERENCES IN BASIC DECISION SKILLS AND STRATEGIES 380
AGE DIFFERENCES IN CONSUMER CHOICE AND DECISION MAKING 383
MODERATING INFLUENCES ON AGING AND DECISION MAKING 386
CONCLUSIONS 394
References 395
Chapter18 - A Framework for Decision Making in Couples across Adulthood 400
A FRAMEWORK FOR UNDERSTANDING DYADIC DECISION-MAKING PROCESSES 401
EXISTING LITERATURE ON DYADIC DECISION MAKING 408
FUTURE DIRECTIONS 414
CONCLUSION 416
References 417
Index 422

Foreword


Decision Making and Aging: Emerging Findings and Research Needs


We are approaching a major demographic shift in the United States and globally, such that the number of individuals over the age of 65 will exceed the number under the age of 5, with no outlook for reversal of this trend in the foreseeable future (National Institute on Aging/World Health Organization, 2011). Contrary to popular stereotypes of aging, the majority of these older adults (at least in the United States) will be living at home, in the community, and will be free of dementia and major disability well into their 70s and early 80s (U.S. Census, 2014). Moreover, as many research and community surveys have revealed, as long as individuals remain in reasonably good health, life satisfaction and emotional well-being improve with age (Carstensen et al., 2011; Mroczek & Kolarz, 1998; Stone, Schwartz, Broderick, & Deaton, 2010). These observations suggest that the older adult population represents a large and potentially untapped resource in our society. But it also poses significant challenges.
Societies have begun to take a serious look at the implications of this demographic shift for policies related to health care, pensions, and retirement, among other domains. Individuals, in turn, are increasingly reminded—through the media, but also in workplaces and health-care contexts—that remaining independent into their later years will require careful planning and decision making in an array of financial and health domains. For example, the decisions that working-age adults make about retirement savings and insurance coverage in their 40s and 50s will determine their ability to sustain current lifestyles, buffer against health shocks, and provide for long-term care needs. Individuals also face decisions about health care and illness management—for themselves and for their family members—as well as decisions regarding preferences for end-of-life care in anticipation of future infirmity or incapacity. The ability to make sound decisions for the short and long term is also essential to optimal functioning in the workplace, as more individuals seek ways to extend their productive working lives into older age. These are the consequential decisions that first come to mind when considering the major decision-making challenges associated with aging.
Perhaps less salient, but no less consequential, are the multiple, small decisions taken over the course of adulthood that collectively impact quality of life at older ages. How well individuals age—and how long they live—depends in part on a series of daily decisions, often taken without much deliberation, regarding engagement in and adherence to health behaviors and regimens, or about small expenditures of financial resources, social capital, and cognitive effort, all of which exist in finite supply. These are decisions that draw on individuals’ capacity for self-regulation and self-control, their ability to keep long-term goals in mind, and their willingness to place appropriate value on their future well-being. The cumulative impact of these small choices can constrain future choices and make the difference between arriving at older age in good health, with cognitive capacity intact, and with the resources permitting the exercise of these assets in pursuit of well-being, versus encountering older age with compromised health and cognitive function, or without the financial wherewithal to address age-related challenges. How well equipped are middle-aged and older adults to make adaptive decisions across these many domains?
The chapters in this volume represent an effort to identify both the strengths and weaknesses of decision making in, and in anticipation of, older age. The authors represent perspectives on decision making that derive primarily from psychology and neuroscience, where the key questions concern the cognitive, emotional, and motivational capacities older adults bring to the decision context, and age-related changes in these processes and the neural systems that support them. This kind of basic science orientation lays essential groundwork for the design of decision-supportive interventions for adaptive aging. Throughout the volume, there is also a deep appreciation of the broad range of domains (e.g., health care, finances) and contexts (e.g., with intimate partners and family members, with health-care providers, in the consumer marketplace) in which decisions take place, and of the need for an appreciation of the interaction between individual capacities and context variables in the design of interventions.

Open Questions


Psychologists who study aging have postulated that negotiating the challenges of later life requires careful balancing of strengths gained through years of life experience and accumulated expertise, against vulnerabilities associated with the normal declines that accompany older age (Baltes, 1997; Carstensen, Isaacowitz, & Charles, 1999; Charles, 2010). Over the past decade or so, there has been a clear recognition, common across the decision sciences, of the interdependence among—and trade-offs between—cognitive capacities (which support the processing of information about alternatives, probabilities, risks, and rewards) and emotional functions (which reflect subjective values and preferences and are involved in forecasting the impact of choices on subjective well-being in the long term) (Coricelli, Dolan, & Sirigu, 2007; Rolls & Grabenhorst, 2008; Weber & Johnson, 2009). Aging throws a unique light on this interaction, as the balance of strengths and vulnerabilities shifts. There is evidence that as cognitive flexibility of youth wanes, individuals may increasingly draw on expertise, learned heuristics, and emotional maturity to tackle decisions. Whether these shifts in capacity enhance or undermine decision making is a topic of considerable research attention (Hess & Kotter-Grühn, 2011; Morrow et al., 2009). The more we learn about the specific cognitive and affective processes that account for age-related changes in decision making, the more precisely we can target interventions to compensate for vulnerabilities and leverage strengths.
Older age is also associated with both shifts in social goals and changes in social relationships and contexts. Yet our understanding of the impact of these changes on decision making remains limited. It is possible that changes in both goals and contexts affect the extent to which interpersonal processes, such as coercion, trust, competition, generativity, and empathy, influence decisions in health and financial domains (see, for example, Beadle et al., 2012; Castle et al., 2012). Age groups may also differ in the degree to which self-regarding versus other-regarding motives take priority, and in their susceptibility to the influence of peers, family members, the media, professional advisors, or service providers. Sociodemographic factors may moderate these influences, with differences in wealth, education, and occupational status exerting powerful effects both on the ability to make sound choices and on the array of choices available.
Several of the chapters in this volume highlight the importance of strategies and strategy selection for adaptive decision making. This area of inquiry holds considerable potential for research on decision making in aging. For example, research has suggested that older age is associated with improvements in emotion regulation, and that emotional regulatory strategies may underlie some age differences in decision making, yet psychologists are only beginning to explore the precise strategies that older adults bring to bear to regulate emotions (Isaacowitz & Blanchard-Fields, 2012; Urry & Gross, 2010). There is evidence to suggest that older adults are capable of employing strategies along the full emotion-regulation continuum (Gross, 1998). They engage in early-stage situation selection (Robenpor, Skogsberg, & Isaacowitz, 2013)—including avoiding situations that will lead to adverse outcomes and choosing those that promise to yield emotional rewards. They are also able, when immersed in a choice context, to selectively attend to certain information (Lohani & Isaacowitz, 2014; Löckenhoff & Carstensen, 2007). And they exhibit the ability to engage in later-stage reappraisal involving the potentially more cognitively taxing “reframing” of current experiences to facilitate better coping (Lohani & Isaacowitz, 2014; Mather, Shafir, & Johnson, 2000). Effective decision-supportive interventions may require careful analysis of decision context features and individual emotional regulatory strengths, while also accounting for biases of particular age groups—that is, a person-by-context-by-strategy framework rather than a “one size fits all” approach (Tucker, Feuerstein, Mende-Siedlecki, Ochsner, & Stern, 2012).

A Research Agenda for the Future


Interdisciplinary research on the cognitive, affective, and social influences on decision making in aging has been growing over the past decade, encouraged, in part, by research initiatives at the National Institute on Aging (2006, 2010c, 2011) and the National Institutes of Health (2010, 2012). These include efforts to stimulate research in neuroeconomics and behavioral economics of aging, as well as basic research on decision making and on mechanisms of behavior change. The integration of approaches from psychology, economics, and neuroscience in neuroeconomics is shedding new light on foundations of decision making and choice...

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