Decision-making deficits in normal elderly persons associated with executive personality disturbances

ABSTRACT Background: The problems that some community-dwelling elderly persons develop in real-world decision-making may have disastrous consequences for their health and financial well-being. Investigations across the adult life span have identified personality as an important individual differences variable that is related to decision-making ability. The aim of this study was to investigate the relationship between personality characteristics, as rated by an informant, and complex decision-making performance among elderly persons. It was hypothesized that deficits in decision-making would be associated with personality characteristics reflecting weak executive functioning (Lack of Planning, Poor Judgment, Lack of Persistence, Perseveration, Lack of Initiative, Impulsivity, and Indecisiveness). Methods: Fifty-eight elderly persons participated. Their health and cognitive status were deemed intact via comprehensive neuropsychological evaluation. The Iowa Scales of Personality, completed by an informant, was used to assess personality characteristics, and the Iowa Gambling Task, completed by the participant, was used to assess complex decision-making abilities. Results: Longstanding disturbances in executive personality characteristics were found to be associated with poor decision-making, and these disturbances remained predictive of poor decision-making even after taking into consideration demographic, neuropsychological, and mood factors. Acquired personality disturbances did not add significantly to prediction after longstanding disturbances were taken into account. Disturbances in other dimensions of personality were not significantly associated with poor decision-making. Conclusions: Our study suggests that attentiveness to the personality correlates of difficulties with aspects of executive functioning over the adult years could enhance the ability to identify older individuals at risk for problems with real-world decision-making.

[1]  J. Gläscher,et al.  Lesion mapping of cognitive control and value-based decision making in the prefrontal cortex , 2012, Proceedings of the National Academy of Sciences.

[2]  D. Tranel,et al.  Dimensions of personality disturbance after focal brain damage: Investigation with the Iowa Scales of Personality Change , 2011, Journal of clinical and experimental neuropsychology.

[3]  Keith E Stanovich,et al.  Decision-making and cognitive abilities: A review of associations between Iowa Gambling Task performance, executive functions, and intelligence. , 2010, Clinical psychology review.

[4]  J. Suhr,et al.  Who fails the Iowa Gambling Test (IGT)? Personality, neuropsychological, and near-infrared spectroscopy findings in healthy young controls. , 2010, Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists.

[5]  D. Tranel,et al.  Poor Decision Making Among Older Adults Is Related to Elevated Levels of Neuroticism , 2009, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[6]  P. Muris,et al.  Impulsivity is associated with behavioral decision-making deficits , 2008, Psychiatry Research.

[7]  Catherine A. Cole,et al.  The Orbitofrontal Cortex, Real‐World Decision Making, and Normal Aging , 2007, Annals of the New York Academy of Sciences.

[8]  A. Bechara,et al.  Decisions under ambiguity and decisions under risk: Correlations with executive functions and comparisons of two different gambling tasks with implicit and explicit rules , 2007, Journal of clinical and experimental neuropsychology.

[9]  D. Tranel,et al.  Psychophysiological anticipation of positive outcomes promotes advantageous decision-making in normal older persons. , 2006, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[10]  D. Tranel,et al.  The ability to decide advantageously declines prematurely in some normal older persons , 2005, Neuropsychologia.

[11]  A. Bechara,et al.  Impulsivity and Decision Making , 2005, The Journal of nervous and mental disease.

[12]  R. Cabeza,et al.  Cognitive neuroscience of aging : linking cognitive and cerebral aging , 2004 .

[13]  S. Whiteside,et al.  The Five Factor Model and impulsivity: using a structural model of personality to understand impulsivity , 2001 .

[14]  D. Tranel,et al.  Acquired Personality Disturbances Associated With Bilateral Damage to the Ventromedial Prefrontal Region , 2000, Developmental neuropsychology.

[15]  F. Hobbs,et al.  65+ in the United States. , 1996 .

[16]  C. Carver,et al.  Behavioral inhibition, behavioral activation, and affective responses to impending reward and punishment: The BIS/BAS Scales , 1994 .

[17]  C. Davis,et al.  Personality traits associated with decision-making deficits , 2007 .

[18]  C. Carter,et al.  Tryptophan Depletion Alters the Decision-Making of Healthy Volunteers through Altered Processing of Reward Cues , 2003, Neuropsychopharmacology.

[19]  A. Benton,et al.  A 10‐year longitudinal study of cognitive changes in elderly persons , 1997 .

[20]  Daniel Tranel,et al.  Development of the concept of "executive function" and its relationship to the frontal lobes , 1994 .

[21]  P. Costa,et al.  Revised NEO Personality Inventory (NEO-PI-R) and NEO-Five-Factor Inventory (NEO-FFI) , 1992 .