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Mild cognitive impairment is associated with poorer decision-making in community-based older persons.

Authors
Han SD, Boyle PA, James BD, Yu L, Bennett DA
Objective
To test the hypothesis that mild cognitive impairment (MCI) is associated with poorer financial and healthcare decision-making.
Design
Community-based epidemiological cohort study.
Setting
Communities throughout northeastern Illinois.
Participants
Older persons without dementia from the Rush Memory and Aging Project (N = 730).
Measurements
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.
Conclusion
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.

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Special Thanks to Judith D. Tamkin

We are sincerely appreciative to Judith D. Tamkin for her gift to help establish the USC Center on Elder Mistreatment’s website. Her deep and personal commitment to eradicating elder abuse is helping to reshape our understanding of elder abuse and ultimately save innumerable older adults from abuse and neglect.