Poor decision making is associated with an increased risk of mortality among community-dwelling older persons without dementia.
BACKGROUND
Decision making is thought to be an important determinant of health and well-being across the lifespan, but little is known about the association of decision making with mortality.


METHODS
Participants were 675 older persons without dementia from the Rush Memory and Aging Project, a longitudinal cohort study of aging. Baseline assessments of decision making were used to predict the risk of mortality during up to 4 years of follow-up.


RESULTS
The mean score on the decision making measure at baseline was 7.1 (SD = 2.9, range: 0-12), with lower scores indicating poorer decision making. During up to 4 years of follow-up (mean = 1.7 years), 40 (6% of 675) persons died. In a proportional hazards model adjusted for age, sex and education, the risk of mortality increased by about 20% for each additional decision making error (HR = 1.19, 95% CI = 1.07-1.32, p = 0.002). Thus, a person who performed poorly on the measure of decision making (score = 3, 10th percentile) was about 4 times more likely to die compared to a person who performed well (score = 11, 90th percentile). Further, the association of decision making with mortality persisted after adjustment for the level of cognitive function.


CONCLUSIONS
Poor decision making is associated with an increased risk of mortality in old age even after accounting for cognitive function.
Rush Alzheimer's Disease Center 600 S. Paulina, Suite 1020B, Chicago, IL 60612, USA. Patricia_Boyle @ rush.edu
Patricia A
PA
Boyle
Robert S
RS
Wilson
Lei
L
Yu
Aron S
AS
Buchman
David A
DA
Bennett
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D003071:Cognition; D003657:Decision Making; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008568:Memory; D009026:Mortality; D009483:Neuropsychological Tests; D012306:Risk