title: Mild cognitive impairment is associated with poorer decision-making in community-based older persons.
abstract: OBJECTIVE
  To test the hypothesis that mild cognitive impairment (MCI) is associated with poorer financial and healthcare decision-making.
  
  
  METHODS
  Community-based epidemiological cohort study.
  
  
  METHODS
  Communities throughout northeastern Illinois.
  
  
  METHODS
  Older persons without dementia from the Rush Memory and Aging Project (N = 730).
  
  
  METHODS
  All participants underwent a detailed clinical evaluation and decision-making assessment using a measure that closely approximates materials used in real-world financial and healthcare settings. This allowed for measurement of total decision-making and financial and healthcare decision-making. Regression models were used to examine whether MCI was associated with a lower level of decision-making. In subsequent analyses, the relationship between specific cognitive systems (episodic memory, semantic memory, working memory, perceptual speed, visuospatial ability) and decision-making was explored in participants with MCI.
  
  
  RESULTS
  MCI was associated with lower total, financial, and healthcare decision-making scores after accounting for the effects of age, education, and sex. The effect of MCI on total decision-making was equivalent to the effect of more than 10 additional years of age. Additional models showed that, when considering multiple cognitive systems, perceptual speed accounted for the most variance in decision-making in participants with MCI.
  
  
  CONCLUSIONS
  Persons with MCI may have poorer financial and healthcare decision-making in real-world situations, and perceptual speed may be an important contributor to poorer decision-making in persons with MCI.
authors: Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois; Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois; Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois; Mental Health Care Group, Veterans Affairs Long Beach Healthcare System, Long Beach, California.
authors: S Duke
authors: SD
authors: Han
authors: Patricia A
authors: PA
authors: Boyle
authors: Bryan D
authors: BD
authors: James
authors: Lei
authors: L
authors: Yu
authors: David A
authors: DA
authors: Bennett
mesh_terms: D000367:Age Factors; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000523:psychology*; D015331:Cohort Studies; D003657:Decision Making; D003695:Delivery of Health Care; D004522:Educational Status; D004812:Epidemiologic Methods; D005260:Female; D005376:Financial Management; D006801:Humans; D007087:Illinois; D057187:Independent Living; D008297:Male; D012044:Regression Analysis; D012737:Sex Factors
keywords: cognition; decision-making; mild cognitive impairment; perceptual speed