Aging, uncertainty, and decision making-A review.

There is a great deal of uncertainty in the world. One common source of uncertainty results from incomplete or missing information about probabilistic outcomes (i.e., outcomes that may occur), which influences how people make decisions. The impact of this type of uncertainty may particularly pronounced for older adults, who, as the primary leaders around the world, make highly impactful decisions with lasting outcomes. This review examines the ways in which uncertainty about probabilistic outcomes is perceived, handled, and represented in the aging brain, with an emphasis on how uncertainty may specifically affect decision making in later life. We describe the role of uncertainty in decision making and aging from four perspectives, including 1) theoretical, 2) self-report, 3) behavioral, and 4) neuroscientific. We report evidence of any age-related differences in uncertainty among these contexts and describe how these changes may affect decision making. We then integrate the findings across the distinct perspectives, followed by a discussion of important future directions for research on aging and uncertainty, including prospection, domain-specificity in risk-taking behaviors, and choice overload.

Individual Differences in Dopamine Are Associated with Reward Discounting in Clinical Groups But Not in Healthy Adults.

Some people are more willing to make immediate, risky, or costly reward-focused choices than others, which has been hypothesized to be associated with individual differences in dopamine (DA) function. In two studies using PET imaging, one empirical (Study 1: N = 144 males and females across 3 samples) and one meta-analytic (Study 2: N = 307 across 12 samples), we sought to characterize associations between individual differences in DA and time, probability, and physical effort discounting in human adults. Study 1 demonstrated that individual differences in DA D2-like receptors were not associated with time or probability discounting of monetary rewards in healthy humans, and associations with physical effort discounting were inconsistent across adults of different ages. Meta-analytic results for temporal discounting corroborated our empirical finding for minimal effect of DA measures on discounting in healthy individuals but suggested that associations between individual differences in DA and reward discounting depend on clinical features. Addictions were characterized by negative correlations between DA and discounting, but other clinical conditions, such as Parkinson's disease, obesity, and attention-deficit/hyperactivity disorder, were characterized by positive correlations between DA and discounting. Together, the results suggest that trait differences in discounting in healthy adults do not appear to be strongly associated with individual differences in D2-like receptors. The difference in meta-analytic correlation effects between healthy controls and individuals with psychopathology suggests that individual difference findings related to DA and reward discounting in clinical samples may not be reliably generalized to healthy controls, and vice versa.SIGNIFICANCE STATEMENT Decisions to forgo large rewards for smaller ones due to increasing time delays, uncertainty, or physical effort have been linked to differences in dopamine (DA) function, which is disrupted in some forms of psychopathology. It remains unclear whether alterations in DA function associated with psychopathology also extend to explaining associations between DA function and decision making in healthy individuals. We show that individual differences in DA D2 receptor availability are not consistently related to monetary discounting of time, probability, or physical effort in healthy individuals across a broad age range. By contrast, we suggest that psychopathology accounts for observed inconsistencies in the relationship between measures of DA function and reward discounting behavior.

Differential regional decline in dopamine receptor availability across adulthood: Linear and nonlinear effects of age.

Theories of adult brain development, based on neuropsychological test results and structural neuroimaging, suggest differential rates of age-related change in function across cortical and subcortical sub-regions. However, it remains unclear if these trends also extend to the aging dopamine system. Here we examined cross-sectional adult age differences in estimates of D2-like receptor binding potential across several cortical and subcortical brain regions using PET imaging and the radiotracer [18 F]Fallypride in two samples of healthy human adults (combined N = 132). After accounting for regional differences in overall radioligand binding, estimated percent difference in receptor binding potential by decade (linear effects) were highest in most temporal and frontal cortical regions (~6-16% per decade), moderate in parahippocampal gyrus, pregenual frontal cortex, fusiform gyrus, caudate, putamen, thalamus, and amygdala (~3-5%), and weakest in subcallosal frontal cortex, ventral striatum, pallidum, and hippocampus (~0-2%). Some regions showed linear effects of age while many showed curvilinear effects such that binding potential declined from young adulthood to middle age and then was relatively stable until old age. Overall, these data indicate that the rate and pattern of decline in D2 receptor availability is regionally heterogeneous. However, the differences across regions were challenging to organize within existing theories of brain development and did not show the same pattern of regional change that has been observed in gray matter volume, white matter integrity, or cognitive performance. This variation suggests that existing theories of adult brain development may need to be modified to better account for the spatial dynamics of dopaminergic system aging.

Individual differences in skewed financial risk-taking across the adult life span.

Older adults are disproportionately targeted by fraud schemes that advertise unlikely but large returns (positively skewed risks). We examined adult age differences in choice and neural activity as individuals considered risky gambles. Gambles were symmetric (50% chance of modest win or loss), positively skewed (25% chance of large gain), or negatively skewed (25% chance of large loss). The willingness to accept positively skewed relative to symmetric gambles increased with age, and this effect replicated in an independent behavioral study. Whole-brain functional magnetic resonance imaging analyses comparing positively (vs. negatively) skewed trials revealed that relative to younger adults, older adults showed increased anticipatory activity for negatively skewed gambles but reduced activity for positively skewed gambles in the anterior cingulate and lateral prefrontal regions. Individuals who were more biased toward positively skewed gambles showed increased activity in a network of regions including the nucleus accumbens. These results reveal age biases toward positively skewed gambles and age differences in corticostriatal regions during skewed risk-taking, and have implications for identifying financial decision biases across adulthood.

Task-related functional connectivity of the caudate mediates the association between trait mindfulness and implicit learning in older adults.

Accumulating evidence shows a positive relationship between mindfulness and explicit cognitive functioning, i.e., that which occurs with conscious intent and awareness. However, recent evidence suggests that there may be a negative relationship between mindfulness and implicit types of learning, or those that occur without conscious awareness or intent. Here we examined the neural mechanisms underlying the recently reported negative relationship between dispositional mindfulness and implicit probabilistic sequence learning in both younger and older adults. We tested the hypothesis that the relationship is mediated by communication, or functional connectivity, of brain regions once traditionally considered to be central to dissociable learning systems: the caudate, medial temporal lobe (MTL), and prefrontal cortex (PFC). We first replicated the negative relationship between mindfulness and implicit learning in a sample of healthy older adults (60-90 years old) who completed three event-related runs of an implicit sequence learning task. Then, using a seed-based connectivity approach, we identified task-related connectivity associated with individual differences in both learning and mindfulness. The main finding was that caudate-MTL connectivity (bilaterally) was positively correlated with learning and negatively correlated with mindfulness. Further, the strength of task-related connectivity between these regions mediated the negative relationship between mindfulness and learning. This pattern of results was limited to the older adults. Thus, at least in healthy older adults, the functional communication between two interactive learning-relevant systems can account for the relationship between mindfulness and implicit probabilistic sequence learning.

Boundary Conditions for the Positive Skew Bias.

Gambles that involve a large but unlikely gain coupled with a small but likely loss-like a lottery ticket-are known as positively-skewed. There is evidence that people tend to prefer these positively skewed choices, leading to what is called a positive-skew bias. In this study, we attempt to better understand under what conditions people are more drawn toward positively skewed, relative to symmetric, gambles. Based on the animal literature, there is reason to believe that preference for skewed gambles is dependent on the strength of the skew, with a greater preference for more strongly skewed options. In two online studies (Study 1: N = 209; Study 2: N = 210), healthy participants across the lifespan (ages 22-85) made a series of choices between a positively skewed risky gamble and either a certain outcome (Study 1) or risky symmetric gamble (Study 2). Logistic regression analyses revealed that people were more likely to choose moderately- and strongly skewed gambles over certain outcomes, with the exception of when there were large potential losses (Study 1). However, a stronger skewness did not increase preference for positively skewed gambles over symmetric gambles, findings which also may depend on the valence of the expected outcome (Study 2). Taken together, these results suggest that there may be a greater preference for more strongly positively skewed gambles but it 1) is dependent on what other gamble is presented and 2) is most prevalent for positive expected values. Additionally, contrary to previous findings, we did not find strong evidence of an age-related increase in positive skew bias in either study. However, exploratory analyses revealed that decision making strategy and cognitive abilities may play a role.

Adult age-related differences in susceptibility to social conformity pressures in self-control over daily desires.

Developmental literature suggests that susceptibility to social conformity pressure peaks in adolescence and disappears with maturity into early adulthood. Predictions about these behaviors are less clear for middle-aged and older adults. On the one hand, while age-related increases in prioritization of socioemotional goals might predict greater susceptibility to social conformity pressures, aging is also associated with enhanced emotion regulation that could support resistance to conformity pressures. In this exploratory research study, we used mobile experience sampling surveys to naturalistically track how 157 healthy adults between the ages of 18 and 80 practice self-control over spontaneous desires in daily life. Many of these desires were experienced in the presence of others enacting that desire. Results showed that middle-aged and older adults were better at controlling their desires than younger adults when desires were experienced in the presence of others enacting that desire. Consistent with the literature on improved emotion regulation with age, these results provide evidence that the ability to resist social conformity pressure is enhanced across the adult life span. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Adult Age Differences in Evoked Emotional Responses to Dynamic Facial Expressions.

OBJECTIVES: Facial expressions are powerful social signals that motivate feelings and actions in the observer. Research on face processing has overwhelmingly used static facial images, which have limited ecological validity. Previous research on the age-related positivity effect and age differences in social motivation suggest that older adults might experience different evoked emotional responses to facial expressions than younger adults. Here, we introduce a new method to explore age-related differences in evoked responses to dynamic facial expressions across adulthood. METHODS: We used dynamic facial expressions which varied by expression type (happy, sad, and angry) and expression magnitude (low, medium, and full) to gather participant ratings on their evoked emotional response to these stimuli along the dimensions of valence (positive vs negative) and arousal. RESULTS: As predicted, older adults rated the emotions evoked by positive facial expressions (happy) more positively than younger adults. Furthermore, older adults rated the emotion evoked by negative facial expressions (angry and sad) more negatively than younger adults. Contrary to our predictions, older adults did not differ significantly in arousal to negative expressions compared with younger adults. Across all ages, individuals rated positive expressions as more arousing than negative expressions. DISCUSSION: The findings provide some evidence that older adults may be more sensitive to variations in dynamic facial expressions than younger adults, particularly in terms of their estimates of valence. These dynamic facial stimuli that vary in magnitude are promising for future studies of more naturalistic affect elicitation, studies of social incentive processing, and use in incentive-driven choice tasks.

Multivariate associations between dopamine receptor availability and risky investment decision-making across adulthood.

Enhancing dopamine increases financial risk taking across adulthood but it is unclear whether baseline individual differences in dopamine function are related to risky financial decisions. Here, thirty-five healthy adults completed an incentive-compatible risky investment decision task and a PET scan at rest using [11C]FLB457 to assess dopamine D2-like receptor availability. Participants made choices between a safe asset (bond) and a risky asset (stock) with either an expected value less than the bond ("bad stock") or expected value greater than the bond ("good stock"). Five measures of behavior (choice inflexibility, risk seeking, suboptimal investment) and beliefs (absolute error, optimism) were computed and D2-like binding potential was extracted from four brain regions of interest (midbrain, amygdala, anterior cingulate, insula). We used canonical correlation analysis to evaluate multivariate associations between decision-making and dopamine function controlling for age. Decomposition of the first dimension (r = 0.76) revealed that the strongest associations were between measures of choice inflexibility, incorrect choice, optimism, amygdala binding potential, and age. Follow-up univariate analyses revealed that amygdala binding potential and age were both independently associated with choice inflexibility. The findings suggest that individual differences in dopamine function may be associated with financial risk taking in healthy adults.

Age-related differences in the social associative learning of trust information.

Trust is a key component of social interaction. Older adults, however, often exhibit excessive trust relative to younger adults. One explanation is that older adults may learn to trust differently than younger adults. Here, we examine how younger (N = 33) and older adults (N = 30) learn to trust over time. Participants completed a classic iterative trust game with 3 partners. Younger and older adults shared similar amounts but differed in how they shared money. Compared to younger adults, older adults invested more with untrustworthy partners and less with trustworthy partners. As a group, older adults displayed less learning than younger adults. However, computational modeling suggests that this is not because older adults learn differently from positive and negative feedback than younger adults. Model-based fMRI analyses revealed several age- and learning-related differences in neural processing. Specifically, we found that older learners (N = 19), relative to older non-learners (N = 11), had greater reputation-related activity in metalizing/memory areas while making their decisions. Collectively, these findings suggest that older adult learners use social cues differently from non-learners.

Decision Making across Adulthood during Physical Distancing.

Covid-19-related social-distancing measures have dramatically limited physical social contact between individuals and increased monetary and health concerns for individuals of all ages. We wondered how these new societal conditions would impact the choices individuals make about monetary, health, and social rewards, and if these unprecedented conditions would have a differential impact on older individuals. We conducted two online studies to examine temporal discounting of monetary, health, and social rewards; stated preferences for monetary, health, and social rewards; and physical distancing behaviors. Both studies recruited equal numbers of White/Caucasian, Black/African American, and Hispanic/Latinx participants. We found that older adults were more likely to prefer smaller, sooner social and health-related rewards in decision-making tasks. These data further support the assertion that older adults have increased motivation for social and health rewards compared to younger individuals and that these age differences in motivation are important to consider when examining decision-making across the adult life span.

Temporal discounting across adulthood: A systematic review and meta-analysis.

A number of developmental theories have been proposed that make differential predictions about the links between age and temporal discounting, or the devaluation of future rewards. Most empirical studies examining adult age differences in temporal discounting have relied on economic intertemporal choice tasks, which pit choosing a smaller, sooner monetary reward against choosing a larger, later one. Although initial studies using these tasks suggested older adults discount less than younger adults, follow-up studies provided heterogeneous, and thus inconclusive, results. Using an open science approach, we test the replicability of adult age differences in temporal discounting by conducting a preregistered systematic literature search and meta-analysis of adult age differences in intertemporal choice tasks. Across 37 cross-sectional studies (Total N = 104,737), a planned meta-analysis found no sizeable relation between age and temporal discounting, r = -0.068, 95% CI [-0.170, 0.035]. We also found little evidence of publication bias or p-hacking. Exploratory analyses of moderators found no effect of research design (e.g., extreme-group vs. continuous age), incentives (hypothetical vs. real rewards), duration of delay (e.g., days, weeks, months, or years), or quantification of discounting behavior (e.g., proportion of immediate choices vs. parameters from computational modeling). Additional analyses of 12 participant-level data sets found little support for a nonlinear relation between age and temporal discounting across adulthood. Overall, the results suggest that younger, middle-aged, and older adults show similar preferences for smaller, sooner over larger, later rewards. We provide recommendations for future empirical work on temporal discounting across the adult life span. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Development and Validation of Social Motivation Questionnaire.

BACKGROUND AND OBJECTIVES: Information-seeking (IS) and emotion-regulatory (ER) motivation play meaningful roles in age-related changes in social interaction across adulthood. This study aimed to develop and validate the Social Motivation Questionnaire (SMQ) to assess these two types of motivation. RESEARCH DESIGN AND METHODS: Ten items were selected from a pool as the candidate items of SMQ and were administered to 480 German adults (20-91 years old) for validation. These items were also administered to 150 U.S. (18-40 years old) and 131 Hong Kong younger adults (18 to 26 years old) for cultural-invariance examination. RESULTS: Exploratory and confirmatory factor analyses showed that a two-factor, eight-item structure fits the German adults' data well with satisfactory reliability. Multigroup comparisons showed cross-age invariance among younger, middle-aged, and older German adults, as well as cross-cultural invariance among German, U.S., and Hong Kong younger adults. DISCUSSION AND IMPLICATIONS: A new questionnaire, SMQ, was developed and validated to measure IS and ER social motivation across adulthood and across cultures.

Partial-volume correction increases estimated dopamine D2-like receptor binding potential and reduces adult age differences.

The relatively modest spatial resolution of positron emission tomography (PET) increases the likelihood of partial volume effects such that binding potential (BPND) may be underestimated. Given structural grey matter losses across adulthood, partial volume effects may be even more problematic in older age leading to overestimation of adult age differences. Here we examined the effects of partial volume correction (PVC) in two studies from different sites using different high-affinity D2-like radioligands (18 F-Fallypride, 11C-FLB457) and different PET camera resolutions (∼5 mm, 2.5 mm). Results across both data sets revealed that PVC increased estimated BPND and reduced, though did not eliminate, age effects on BPND. As expected, the effects of PVC were smaller in higher compared to lower resolution data. Analyses using uncorrected data that controlled for grey matter volume in each region of interest approximated PVC corrected data for some but not all regions. Overall, the findings suggest that PVC increases estimated BPND in general and reduces adult age differences especially when using lower resolution cameras. The findings suggest that the past 30 years of research on dopamine receptor availability, for which very few studies use PVC, may overestimate effects of aging on dopamine receptor availability.

Reproducibility of the correlative triad among aging, dopamine receptor availability, and cognition.

The evidence that dopamine function mediates the association between aging and cognition is one of the most cited findings in the cognitive neuroscience of aging. However, few and relatively small studies have directly examined these associations. Here we examined correlations among adult age, dopamine D2-like receptor (D2R) availability, and cognition in two cross-sectional studies of healthy human adults. Participants completed a short cognitive test battery and, on a separate day, a PET scan with either the high-affinity D2R tracer [18F]Fallypride (Study 1) or [11C]FLB457 (Study 2). Digit span, a measure of short-term memory maintenance and working memory, was the only cognitive test for which dopamine D2R availability partially mediated the age effect on cognition. In Study 1, age was negatively correlated with digit span. Striatal D2R availability was positively correlated with digit span controlling for age. The age effect on digit span was smaller when controlling for striatal D2R availability. Although other cognitive measures used here have individually been associated with age and D2R availability in prior studies, we found no consistent evidence for significant associations between low D2R availability and low cognitive performance on these measures. These results at best only partially supported the correlative triad of age, dopamine D2R availability, and cognition. While a wealth of other research in human and nonhuman animals demonstrates that dopamine makes critical contributions to cognition, the present studies suggest caution in interpreting PET findings as evidence that dopamine D2R loss is a primary cause of broad age-related declines in fluid cognition. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Individual differences in loss aversion and preferences for skewed risks across adulthood.

In a previous study, we found adult age differences in the tendency to accept more positively skewed gambles (with a small chance of a large win) than other equivalent risks, or an age-related positive-skew bias. In the present study, we examined whether loss aversion explained this bias. A total of 508 healthy participants (ages 21-82) completed measures of loss aversion and skew preference. Age was not related to loss aversion. Although loss aversion was a significant predictor of gamble acceptance, it did not influence the age-related positive-skew bias. (PsycINFO Database Record

Subjective value representations during effort, probability and time discounting across adulthood.

Every day, humans make countless decisions that require the integration of information about potential benefits (i.e. rewards) with other decision features (i.e. effort required, probability of an outcome or time delays). Here, we examine the overlap and dissociation of behavioral preferences and neural representations of subjective value in the context of three different decision features (physical effort, probability and time delays) in a healthy adult life span sample. While undergoing functional neuroimaging, participants (N = 75) made incentive compatible choices between a smaller monetary reward with lower physical effort, higher probability, or a shorter time delay versus a larger monetary reward with higher physical effort, lower probability, or a longer time delay. Behavioral preferences were estimated from observed choices, and subjective values were computed using individual hyperbolic discount functions. We found that discount rates were uncorrelated across tasks. Despite this apparent behavioral dissociation between preferences, we found overlapping subjective value-related activity in the medial prefrontal cortex across all three tasks. We found no consistent evidence for age differences in either preferences or the neural representations of subjective value across adulthood. These results suggest that while the tolerance of decision features is behaviorally dissociable, subjective value signals share a common representation across adulthood.

Adult age differences in decision making across domains: Increased discounting of social and health-related rewards.

Although research on aging and decision making continues to grow, the majority of studies examine decisions made to maximize monetary earnings or points. It is not clear whether these results generalize to other types of rewards. To investigate this, we examined adult age differences in 92 healthy participants aged 22 to 83. Participants completed 9 hypothetical discounting tasks, which included 3 types of discounting factors (time, probability, effort) across 3 reward domains (monetary, social, health). Participants made choices between a smaller magnitude reward with a shorter time delay/higher probability/lower level of physical effort required and a larger magnitude reward with a longer time delay/lower probability/higher level of physical effort required. Older compared with younger individuals were more likely to choose options that involved shorter time delays or higher probabilities of experiencing an interaction with a close social partner or receiving health benefits from a hypothetical drug. These findings suggest that older adults may be more motivated than young adults to obtain social and health rewards immediately and with certainty. (PsycINFO Database Record

Adult age differences in subjective and objective measures of strategy use on a sequentially cued prediction task.

Differences in strategy use are thought to underlie age-related performance deficits on many learning and decision-making tasks. Recently, age-related differences in learning to make predictions were reported on the Triplets Prediction Task (TPT). Notably, deficits appeared early in training and continued with experience. To assess if age differences were due to early strategy use, neural networks were used to objectively assess the strategies implemented by participants during Session 1. Then, the relationship between these strategies and performance was examined. Results revealed that older adults were more likely to implement a disadvantageous strategy early in learning, and this led to poorer task performance. Importantly, the relationship between age and task performance was partially mediated by early strategy use, suggesting that early strategy selection played a role in the lower quality of predictions in older adults.

Risky decision-making is associated with residential choice in healthy older adults.

As our society becomes more mobile and people reside farther away from their immediate families, competent decision-making has become critical for the older adults wishing to maintain their independence. However, very little is known about the relationship between residential choice and decision-making. Here we use the Balloon Analog Risk Task (BART) to examine risk-taking in two samples of older adults, one living in a retirement community and another living independently. We also used a cognitive model to gain insight into the cognitive factors underlying decision-making in these groups. We found that older adults living in a retirement community were more risk averse than their independent counterparts. Furthermore, this difference appeared to be motivated by group differences in initial perception of risk. This study suggests an intriguing difference between these two residential groups, and also points to the utility of using laboratory methods in research on real-world problems.