Decision making under uncertainty across the lifespan: Cognitive, motivational and neural bases

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The aging population in the United States is rapidly rising. Older adults face complicated financial and healthcare decisions, which carry substantial consequences for themselves and for their families. It is therefore of high concern that older adults make more financial mistakes compared to their younger counterparts, and that they are increasingly subjected to exploitation by the people around them. A crucial aspect of most of these decisions is that they are made under conditions of high uncertainty. Shifts in behavior under uncertainty may therefore underlie some of the changes in decision making in aging. The cognitive and motivational bases for these shifts, however, are largely unknown. Understanding these bases is important, because it may guide the development of individually-tailored decision aids. This project aims to characterize age-related changes in uncertainty attitudes in the financial and medical domains, and to determine whether these depend on age-related changes in learning from feedback and in sensitivity to rewards and punishments. Our world is highly uncertain and rapidly changing. Individuals vary substantially in their attitudes towards uncertainty: some seek it, while others avoid it at all costs. An important factor that affects individual uncertainty attitudes is age, yet age-related changes are not uniform, but rather they are context-dependent. This suggests that uncertainty attitudes result from interactions between several context-dependent processes. The studies conducted in this project test the general hypothesis that individual differences in decision traits are linked to differences in basic cognitive and motivational processes, and that age-related changes in these basic processes account for age-related changes in decision traits. Specifically, the studies will test the contribution of three basic processes to uncertainty attitudes: the ability to reduce uncertainty by learning from feedback, sensitivity to rewards, and sensitivity to punishments. The researchers will test this hypothesis in a group of cognitively healthy individuals between the ages of 18 and 90, using two behavioral tasks and one functional MRI task. The behavioral tasks will evaluate: (1) individual attitudes towards uncertainty in multiple domains (money gains, money losses and medical treatments), and (2) individual ability to flexibly learn from feedback. Functional neuroimaging will be used to measure neural responses to anticipated rewards and punishments. Resting-state fMRI will also be measured, to evaluate age-related changes in functional connectivity between brain areas that are involved in valuation, learning and choice. All collected data will be deposited in an open platform for neuroimaging data for public use by other investigators. The proposed work will lead to a detailed understanding of the role of learning, as well as reward and punishment processing, in individual uncertainty attitudes, and age-related changes in these attitudes. This understanding will provide constraints for future research on the neural basis of decision making, as well as policy making and decision aids for older adults. It will also serve as the basis for longitudinal and patient studies.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.