Thomas Tannou1,2,3, Séverine Koeberlé4,5, Régis Aubry4,5,6, Emmanuel Haffen6. 1. Geriatrics Department, University Hospital of Besançon, 25000, Besançon, France. ttannou@chu-besancon.fr. 2. Equipe "Ethique et Progrès médical" - Clinical Investigation Centre CIC-IT 808 INSERM, University Hospital of Besançon, 25000, Besançon, France. ttannou@chu-besancon.fr. 3. Laboratoire de Neurosciences Intégratives et Cliniques EA481, Université Bourgogne Franche-Comté, 25000, Besançon, France. ttannou@chu-besancon.fr. 4. Geriatrics Department, University Hospital of Besançon, 25000, Besançon, France. 5. Equipe "Ethique et Progrès médical" - Clinical Investigation Centre CIC-IT 808 INSERM, University Hospital of Besançon, 25000, Besançon, France. 6. Laboratoire de Neurosciences Intégratives et Cliniques EA481, Université Bourgogne Franche-Comté, 25000, Besançon, France.
Abstract
PURPOSE: Aging is associated with increased needs related to complex decisions, particularly in medical and social issues. However, the complexity of decision-making involves many neurological functions and structures which are potentially altered by cognitive aging. METHODOLOGY: A systematic review was conducted in accordance with PRISMA guidelines to examine changes in decision-making occurring in normal cognitive aging. The keywords "decision making" and "normal aging" were used to find the clinical studies and literature reviews focused on these changes. RESULTS: A total of 97 articles were considered in the review, and ultimately 40 articles were selected, including 30 studies and 10 literature reviews. The data from these studies were of uneven quality and too disparate to allow meta-analysis according to PRISMA criteria. Nevertheless, a key result of the analysis is the decrease of processing speed with aging. In ambiguous decision-making situations, the alteration of the ventromedial system is associated with changes in motivation profiles. These changes can be compensated by experience. However, difficulties arise for older adults in the case of one-off decisions, which are very common in the medical or medico-social domains. CONCLUSIONS: Cognitive aging is associated with a slowdown in processing speed of decision-making, especially in ambiguous situations. However, decision-making processes which are based on experience and cases in which sufficient time is available are less affected by aging. These results highlight the relativity of decision-making capacities in cognitive aging.
PURPOSE: Aging is associated with increased needs related to complex decisions, particularly in medical and social issues. However, the complexity of decision-making involves many neurological functions and structures which are potentially altered by cognitive aging. METHODOLOGY: A systematic review was conducted in accordance with PRISMA guidelines to examine changes in decision-making occurring in normal cognitive aging. The keywords "decision making" and "normal aging" were used to find the clinical studies and literature reviews focused on these changes. RESULTS: A total of 97 articles were considered in the review, and ultimately 40 articles were selected, including 30 studies and 10 literature reviews. The data from these studies were of uneven quality and too disparate to allow meta-analysis according to PRISMA criteria. Nevertheless, a key result of the analysis is the decrease of processing speed with aging. In ambiguous decision-making situations, the alteration of the ventromedial system is associated with changes in motivation profiles. These changes can be compensated by experience. However, difficulties arise for older adults in the case of one-off decisions, which are very common in the medical or medico-social domains. CONCLUSIONS: Cognitive aging is associated with a slowdown in processing speed of decision-making, especially in ambiguous situations. However, decision-making processes which are based on experience and cases in which sufficient time is available are less affected by aging. These results highlight the relativity of decision-making capacities in cognitive aging.
Authors: David Moher; Larissa Shamseer; Mike Clarke; Davina Ghersi; Alessandro Liberati; Mark Petticrew; Paul Shekelle; Lesley A Stewart Journal: Syst Rev Date: 2015-01-01
Authors: Patricia A Boyle; Lei Yu; Robert S Wilson; Keith Gamble; Aron S Buchman; David A Bennett Journal: PLoS One Date: 2012-08-20 Impact factor: 3.240