title: Challenges and opportunities for developing and implementing incentives to improve health-related behaviors in older adults.
abstract: There is growing interest in using patient-directed incentives to change health-related behaviors. Advocates of incentive programs have proposed an ambitious research agenda for moving patient incentive programs forward. The unique cognitive and psychological features of older adults, however, present a challenge to this agenda. In particular, age-related changes in emotional regulation, executive function, and cognitive capacities, and a preference for collaborative decision-making raise questions about the suitability of these programs, particularly the structure of current financial incentives, for older adults. Differences in decision-making in older adults need to be accounted for in the design and implementation of financial incentive programs. Financial incentive programs adjusted to characteristics of older adult populations may be more likely to improve the lives of older persons and the economic success of programs that serve them.
authors.affiliation: Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Eran
authors.initials: E
authors.lastname: Klein
authors.forename: Jason
authors.initials: J
authors.lastname: Karlawish
mesh_terms: D000368:Aged; D000375:Aging; D003071:Cognition / Q000502:physiology; D003695:Delivery of Health Care / Q000191:economics; D004644:Emotions / Q000502:physiology; D015577:Geriatric Assessment / Q000379:methods*; D015438:Health Behavior; D006801:Humans; D010816:Physician Incentive Plans / Q000191:economics*; D014481:United States