Decision-Making Profiles and Their Associations with Cognitive Performance in Mild Cognitive Impairment

Article type: Research Article

Authors: Zhang, Ying^{a; b} | Wang, Jing^{a; b; *} | Sun, Tingting^{a; b; c} | Wang, Luchun^{a; b} | Li, Tao^{a; b} | Li, Huizi^{a; b} | Zheng, Yaonan^{a; b} | Fan, Zili^{a; b; d} | Zhang, Ming^{a; b; c} | Tu, Lihui^{a; b; d} | Yu, Xin^{a; b} | Wang, Huali^{a; b; *}

Affiliations: [a] Dementia Care & Research Center, Beijing Dementia Key Lab, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China | [b] National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health, Beijing, China | [c] Department of Psychiatry, the Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China | [d] Beijing Anding Hospital, Capital Medical University, Beijing, China

Correspondence: [*] Correspondence to: Prof. Huali Wang, Dementia Care & Research Center, Peking University Institute of Mental Health, Beijing, 100191, China. E-mail: huali_wang@bjmu.edu.cn and Dr. Jing Wang, Clinical Research Division, Peking University Institute of Mental Health, Beijing, 100191, China. E-mail: 18612112796@163.com.

Abstract: Background:It is crucial for older adults, especially those with mild cognitive impairment (MCI), to make profitable decisions routinely. However, the results regarding decision-making (DM) remain inconsistent. Objective:The present study assessed DM profiles under uncertainty conditions in individuals with MCI and their associations with multi-domain cognitive performance. Method:Fifty-three patients with MCI and forty-two age-, gender-, and education level-matched healthy controls (HCs) were administered a comprehensive neuropsychological battery test. The Iowa Gambling Task (IGT) and Game of Dice Task (GDT) were used to assess DM competence in conditions involving ambiguity and risk, respectively. In addition, Spearman’s correlations were used to examine relationships between GDT and multi-domain cognitive performance. Result:The final capital (FC) and frequency of utilization of negative feedback (FUNF) and positive feedback (FUPF) in the GDT were lower in MCI patients than in HCs. In addition, the number of shifts between safe and risky alternatives was significantly different across groups. However, IGT performance was comparable across groups. In the MCI patients, risky DM performance was associated with language, whereas in HCs was correlated with memory and executive functions. Besides, in MCI, performance on IGT was significantly correlated with social cognition. Conclusion:Individuals with mild cognitive impairment have difficulty utilizing feedback to make optimal decisions under risky situations. The association between decision-making performance and cognitive function is divergent regarding situational uncertainty and individuals’ cognitive status. In mild cognitive impairment and normal aging, decision-making under ambiguity needs further investigation.

Keywords: Ambiguous situation, cognitive function, decision-making, mild cognitive impairment, risky situation, situational uncertainty

DOI: 10.3233/JAD-215440

Journal: Journal of Alzheimer's Disease, vol. 87, no. 3, pp. 1215-1227, 2022