Decision-Making Competence in Older Adults: A Rosy View From a Longitudinal Investigation

Cross-sectional studies have suggested age-related differences in decision-making competence, but these differences may also reflect cohort-related effects. We present a longitudinal study of age-related changes over 5 years in older adults (aged 60-85) for 3 important aspects of decision-making competence: resistance to framing, applying decision rules, and resistance to sunk costs. The findings show small age-related longitudinal declines in resistance to framing but no decline in applying decision rules or resistance to sunk costs. The results also indicate that individuals' decision-making competence after 5 years is significantly related to their initial decision-making competence assessment and that the contribution of crystallized abilities to decision making in older adults is greater than previously thought

Decision-Making Competence: More Than Intelligence?

Decision-making competence refers to the ability to make better decisions, as defined by decision-making principles posited by models of rational choice. Historically, psychological research on decision-making has examined how well people follow these principles under carefully manipulated experimental conditions. When individual differences received attention, researchers often assumed that individuals with higher fluid intelligence would perform better. Here, we describe the development and validation of individual-differences measures of decision-making competence. Emerging findings suggest that decision-making competence may tap not only into fluid intelligence but also into motivation, emotion regulation, and experience (or crystallized intelligence). Although fluid intelligence tends to decline with age, older adults may be able to maintain decision-making competence by leveraging age-related improvements in these other skills. We discuss implications for interventions and future research

Restricting future time perspective reduces failure to act after a missed opportunity

Inaction inertia occurs when missing an attractive opportunity (vs. not having been offered it) decreases the likelihood of acting on another similar opportunity. We experimentally manipulated future time perspective to reduce inaction inertia. Middle-aged and older adults from the Health and Retirement Study were randomly assigned to imagining restricted or expansive time left to live, or to no instructions. Across age, imagining a restricted future (vs. the other two instructions) reduced inaction inertia and future time perspective. Imagining living longer increased future time perspective among relatively younger participants. Consequences of restricted time perspective for decisions and life regrets are discussed

Taking the Biggest First: Age Differences in Preferences for Monetary and Hedonic Sequences

Objectives: People face decisions about how to sequence payments and events, including when to schedule bigger events relative to smaller ones. We examine age differences in these sequence preferences. Methods: We gave a national adult life-span sample (n = 1,296, mean = 53.06 years, standard deviation = 16.33) four scenarios describing a positive or negative hedonic (enjoyable weekends, painful dental procedures) or monetary (receiving versus paying money) event. We considered associations among age, sequence preferences, three self-reported decision-making processes—emphasizing experience, emotion, and reasoning—and two dimensions of future time perspective—focusing on future opportunities and limited time. Results: Older age was associated with taking the “biggest” event sooner instead of later, especially for receiving money, but also for the other three scenarios. Older age was associated with greater reported use of reason and experience and lesser reported use of emotion. These decision-making processes played a role in understanding age differences in sequence preferences, but future time perspective did not. Discussion: We discuss “taking the biggest first” preferences in light of prior mixed findings on age differences in sequence preferences. We highlight the distinct roles of experience- and emotion-based decision-making processes. We propose applications to financial and health-care settings

Age differences in reported social networks and well-being

Social networks can consist of close friends, family members, and neighbors as well as peripheral others. Studies of social networks and associations with well-being have mostly focused on age-restricted samples of older adults or specific geographic areas, thus limiting their generalizability. We analyzed 2 online surveys conducted with RAND’s American Life Panel, a national adult life span sample recruited through multiple probability-based approaches. In Survey 1, 496 participants assessed the sizes of their social networks, including the number of close friends, family members, neighbors, and peripheral others. Of those, 287 rated their social satisfaction and well-being on Survey 2. Older participants reported smaller social networks, largely because of reporting fewer peripheral others. Yet older age was associated with better well-being. Although the reported number of close friends was unrelated to age, it was the main driver of well-being across the life span—even after accounting for the number of family members, neighbors, and peripheral others. However, well-being was more strongly related to social satisfaction than to the reported number of close friends—suggesting that it is the perception of relationship quality rather than the perception of relationship quantity that is relevant to reporting better well-being. We discuss implications for social network interventions that aim to promote well-being

Choosing to be happy? Age differences in 'maximizing' decision strategies and experienced emotional well-being

Maximizing is a decision strategy that seeks the very best option, which is more elaborate and potentially more regret-inducing than choosing an option that is ‘good enough.’ In surveys with a large national sample, we find that older adults are less likely than younger adults to self-report maximizing, which is associated with their better experienced well-being reported two years later. This pattern holds after controlling for demographic characteristics and negative life events. Our findings suggest that older adults could possibly be opting for decision strategies that make them happier. We discuss implications for interventions that aim to improve decision making

The Role of Social Circle Perceptions in “False Consensus” about Population Statistics: Evidence from a National Flu Survey

Purpose. “False consensus” refers to individuals with (v. without) an experience judging that experience as more (v. less) prevalent in the population. We examined the role of people’s perceptions of their social circles (family, friends, and acquaintances) in shaping their population estimates, false consensus patterns, and vaccination intentions. Methods. In a national online flu survey, 351 participants indicated their personal vaccination and flu experiences, assessed the percentage of individuals with those experiences in their social circles and the population, and reported their vaccination intentions. Results. Participants’ population estimates of vaccination coverage and flu prevalence were associated with their perceptions of their social circles’ experiences, independent of their own experiences. Participants reporting less social circle “homophily” (or fewer social contacts sharing their experience) showed less false consensus and even “false uniqueness.” Vaccination intentions were greater among nonvaccinators reporting greater social circle vaccine coverage. Discussion. Social circle perceptions play a role in population estimates and, among individuals who do not vaccinate, vaccination intentions. We discuss implications for the literature on false consensus, false uniqueness, and social norms interventions

Optimal echocardiographic assessment of myocardial dysfunction for arrhythmic risk stratification in phospholamban mutation carriers

AIMS: Phospholamban (PLN) p.Arg14del mutation carriers are at risk of developing malignant ventricular arrhythmias (VAs) and/or heart failure. Currently, left ventricular ejection fraction (LVEF) plays an important role in risk assessment for VA in these individuals. We aimed to study the incremental prognostic value of left ventricular mechanical dispersion (LVMD) by echocardiographic deformation imaging for prediction of sustained VA in PLN p.Arg14del mutation carriers. METHODS AND RESULTS: We included 243 PLN p.Arg14del mutation carriers, which were classified into three groups according to the '45/45' rule: (i) normal left ventricular (LV) function, defined as preserved LVEF ≥45% with normal LVMD ≤45 ms (n = 139), (ii) mechanical LV dysfunction, defined as preserved LVEF ≥45% with abnormal LVMD >45 ms (n = 63), and (iii) overt LV dysfunction, defined as reduced LVEF <45% (n = 41). During a median follow-up of 3.3 (interquartile range 1.8-6.0) years, sustained VA occurred in 35 individuals. The negative predictive value of having normal LV function at baseline was 99% [95% confidence interval (CI): 92-100%] for developing sustained VA. The positive predictive value of mechanical LV dysfunction was 20% (95% CI: 15-27%). Mechanical LV dysfunction was an independent predictor of sustained VA in multivariable analysis [hazard ratio adjusted for VA history: 20.48 (95% CI: 2.57-162.84)]. CONCLUSION: LVMD has incremental prognostic value on top of LVEF in PLN p.Arg14del mutation carriers, particularly in those with preserved LVEF. The '45/45' rule is a practical approach to echocardiographic risk stratification in this challenging group of patients. This approach may also have added value in other diseases where LVEF deterioration is a relative late marker of myocardial dysfunction

Video intervention to increase perceived self-efficacy for condom use in a randomized controlled trial of female adolescents

Study Objective: To assess the effects of the Seventeen Days interactive video on young women’s perceived self-efficacy for using condoms six months after being offered the intervention, relative to a control. Design: Multisite randomized controlled trial. Setting: Twenty participating health clinics and county health departments in Ohio, Pennsylvania, and West Virginia. Participants: Sexually active females ages 14 to 19: Interventions: Seventeen Days (treatment intervention; sex education) versus Driving Skills for Life (control intervention; driving education). Main Outcome Measures: Perceived self-efficacy for condom use. Results and Conclusions: Participants in the Seventeen Days group reported higher perceived condom acquisition self-efficacy after six months than those in the driving group. This finding held after controlling for baseline self-efficacy scores and other covariates. The Seventeen Days program shows promise to improve perceived self-efficacy to acquire condoms among sexually active female adolescents—an important precursor to behavior change