title: Discrepancies between cognition and decision making in older adults.
abstract: OBJECTIVE
  There is increasing clinical and legal interest in discrepancies between decision-making ability and cognition in old age, a stage of life when decisions have major ramifications. We investigated the frequency and correlates of such discrepancies in non-demented older adults participating in a large community-based cohort study of aging, the Rush Memory and Aging Project.
  
  
  METHODS
  Participants [n = 689, mean age 81.8 (SD 7.6), mean education 15.2 (SD 3.1), 76.8 % female and 93.3 % white] completed a measure of financial and healthcare decision making (DM) and a battery of 19 neuropsychological tests from which a composite measure of global cognition (COG) was derived.
  
  
  RESULTS
  Results indicated that 23.9 % of the sample showed a significant discrepancy between DM and COG abilities. Of these, 12.9 % showed DM < COG, while 11.0 % showed DM > COG. Logistic regression models showed older age, being non-white, greater temporal discounting, and greater risk aversion were associated with higher odds of being in the DM < COG group. Being male was associated with higher odds of being in the DM > COG group. Education, income, depressive symptoms, and impulsivity were not associated with a discrepancy. Only demographic associations (age, sex, and race) remained significant in a fully adjusted model with terms included for all factors.
  
  
  CONCLUSIONS
  These results support the consideration of decision making and cognition as potentially separate constructs.
authors.affiliation: Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA. duke_han@rush.edu.|Rush Alzheimer's Disease Center, Rush University Medical Center, 600 S. Paulina St., Suite 1022, Chicago, IL, 60612, USA. duke_han@rush.edu.|Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA. duke_han@rush.edu.|Mental Health Care Group, VA Long Beach Healthcare System, Long Beach, CA, USA. duke_han@rush.edu.
authors.forename: S Duke
authors.initials: SD
authors.lastname: Han
authors.affiliation: Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA.|Rush Alzheimer's Disease Center, Rush University Medical Center, 600 S. Paulina St., Suite 1022, Chicago, IL, 60612, USA.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Boyle
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center, 600 S. Paulina St., Suite 1022, Chicago, IL, 60612, USA.|Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.|Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Bryan D
authors.initials: BD
authors.lastname: James
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center, 600 S. Paulina St., Suite 1022, Chicago, IL, 60612, USA.|Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Lei
authors.initials: L
authors.lastname: Yu
authors.affiliation: Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA.|Rush Alzheimer's Disease Center, Rush University Medical Center, 600 S. Paulina St., Suite 1022, Chicago, IL, 60612, USA.|Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Lisa L
authors.initials: LL
authors.lastname: Barnes
authors.affiliation: Rush Alzheimer's Disease Center, Rush University Medical Center, 600 S. Paulina St., Suite 1022, Chicago, IL, 60612, USA.|Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Bennett
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000208:ethnology / Q000523:psychology; D003071:Cognition; D015331:Cohort Studies; D003657:Decision Making; D003710:Demography; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory; D009483:Neuropsychological Tests; D012959:Socioeconomic Factors; D013223:Statistics as Topic
keywords: Cognition; Decision making; Discrepancy