Decision-making refers to the ability to consider multiple competing alternatives and make a choice, and successful decision-making is critical for maintaining independence and well-being in society. Elderly adults are constantly faced with important decisions, as in financial and health-care matters, and recent work suggests decision-making abilities become significantly impaired with age. Age-related pathological changes in the brain are well documented, suggesting the suboptimal functioning of neural systems may be essential to impaired decision-making in elderly adults. Decision-making can be viewed as the complex interaction of two relatively distinct neural systems: a deliberative cognitive processing system involving executive functions and memory, and an affective system involving personality traits and decision styles. While neuroimaging has yielded some advances in our knowledge of the brain structures and functions involved in these systems in younger populations, relatively little is known about the neuroimaging correlates of pathological changes associated with these systems in elderly adults or how they contribute to impaired decision-making. The overall goal of the proposed Beeson Career Development Award (K23) is to identify the structural and functional neuroimaging correlates of impaired financial and health-care decision-making in non-demented older adults. This will be achieved through the completion of a focused research project which will integrate multi-level neuroimaging methods sensitive to brain structure, function, and connectivity with recent approaches to the study of decision-making;and a comprehensive training program in neuroimaging, decisionmaking, bioethics, geriatrics, neuroepidemiology, biostatistics, and leadership skill development in a highly supportive multi-disciplinary environment. Knowledge of the neural correlates of impaired decision-making behaviors in elderly adults can facilitate targeted pharmacological and behavioral interventions aimed at delaying age-related decline. Many negative financial and health outcomes may therefore be minimized through such knowledge, reducing the emotional toil and economic burden to affected patients, family members, and society.

Public Health Relevance

The overall goal of the proposed Beeson Career Development Award (K23) is to identify the structural and functional neuroimaging correlates of impaired financial and health-care decision-making in non-demented older adults. Knowledge of the neural correlates of impaired decision-making behaviors in elderly adults can facilitate targeted pharmacological and behavioral interventions aimed at delaying age-related decline. Many negative financial and health outcomes may therefore be minimized through such knowledge, reducing the emotional toil and economic burden to affected patients, family members, and society.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
1K23AG040625-01A1
Application #
8366234
Study Section
Special Emphasis Panel (ZAG1-ZIJ-6 (M1))
Program Officer
Nielsen, Lisbeth
Project Start
2012-08-15
Project End
2017-07-31
Budget Start
2012-08-15
Budget End
2013-07-31
Support Year
1
Fiscal Year
2012
Total Cost
$151,585
Indirect Cost
$11,228
Name
Rush University Medical Center
Department
Other Clinical Sciences
Type
Schools of Medicine
DUNS #
068610245
City
Chicago
State
IL
Country
United States
Zip Code
60612
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Han, S Duke; Boyle, Patricia A; Arfanakis, Konstantinos et al. (2016) Financial literacy is associated with white matter integrity in old age. Neuroimage 130:223-9
Han, S Duke; Boyle, Patricia A; James, Bryan D et al. (2016) Discrepancies between cognition and decision making in older adults. Aging Clin Exp Res 28:99-108
Nation, Daniel A; Edmonds, Emily C; Bangen, Katherine J et al. (2015) Pulse pressure in relation to tau-mediated neurodegeneration, cerebral amyloidosis, and progression to dementia in very old adults. JAMA Neurol 72:546-53
Lachs, Mark S; Han, S Duke (2015) Age-Associated Financial Vulnerability: An Emerging Public Health Issue. Ann Intern Med 163:877-8
Han, S Duke; Boyle, Patricia A; James, Bryan D et al. (2015) Mild cognitive impairment is associated with poorer decision-making in community-based older persons. J Am Geriatr Soc 63:676-83
James, Bryan D; Boyle, Patricia A; Yu, Lei et al. (2015) Cognitive decline is associated with risk aversion and temporal discounting in older adults without dementia. PLoS One 10:e0121900
Han, S Duke; Boyle, Patricia A; James, Bryan D et al. (2015) Poorer Financial and Health Literacy Among Community-Dwelling Older Adults With Mild Cognitive Impairment. J Aging Health 27:1105-17
Han, S Duke; Boyle, Patricia A; Yu, Lei et al. (2014) Financial literacy is associated with medial brain region functional connectivity in old age. Arch Gerontol Geriatr 59:429-38

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