Abstract
Background: Risk aversion is associated with many important decisions among younger and middle aged persons, but the association of risk aversion with decision making has not been well studied among older persons who face some of the most significant decisions of their lives. Method: Using data from 606 community-dwelling older persons without dementia from the Rush Memory and Aging Project, an ongoing longitudinal epidemiologic study of aging, we examined the association of risk aversion with decision making. Risk aversion was measured using standard behavioral economics questions in which participants were asked to choose between a certain monetary payment ($15) versus a gamble in which they could gain more than $15 or gain nothing; potential gamble gains ranged from $20 to $300 with the gain amounts varied randomly over questions. Decision making was measured using a 12 item version of the Decision Making Competence Assessment Tool. Findings: In a linear regression model adjusted for age, sex, education, and income, greater risk aversion was associated with poorer decision making [estimate = −1.03, standard error (SE) = 0.35, p = 0.003]. Subsequent analyses showed that the association of risk aversion with decision making persisted after adjustment for global cognitive function as well as executive and non-executive cognitive abilities. Conclusion: Similar to findings from studies of younger persons, risk aversion is associated with poorer decision making among older persons who face a myriad of complex and influential decisions.
Highlights
Every day, people make decisions under conditions of uncertainty in a variety of settings
In a cohort of 606 community-based older persons free of dementia, we found that risk aversion was associated with poorer decision making
The association of risk aversion with decision making persisted after adjustment for cognitive function, including global cognition and executive cognitive abilities
Summary
People make decisions under conditions of uncertainty in a variety of settings (e.g., should I invest in a particular stock? is it safe to cross the street with a car approaching?). The available data suggest that risk aversion is an important determinant of decision making, most studies have involved relatively young persons and little is known about how risk aversion affects decision making in advanced age. This is an important gap in knowledge given that aging is the time when some of life’s most difficult and influential decisions are made (e.g., retirement spending, estate planning, end of life healthcare decisions). Conclusion: Similar to findings from studies of younger persons, risk aversion is associated with poorer decision making among older persons who face a myriad of complex and influential decisions
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