Iowa City, IA, USA. We often read or hear stories about older adults being conned out of their life savings, but are older individuals really more susceptible to fraud than younger adults? And, if so, how exactly does aging affect judgment and decision-making abilities?

 

Recent research suggests that for a significant number of older adults, measurable neuropsychological deficits do seem to lead to poor decision-making and an increased vulnerability to fraud.

 

"Our research suggests that elders who fall prey to fraudulent advertising are not simply gullible, depressed, lonely or less intelligent. Rather, it is truly more of a medical or neurological problem," said Denburg. "Our work sheds new light on this problem and perhaps may lead to a way to identify people at risk of being deceived."

 

Being able to identify how aging affects judgment and decision-making abilities could have broad societal implications. How to combat deceptive advertising targeted at older individuals — some of whom appear to be particularly vulnerable to fraud — is one important area of concern. In addition, older age is a time when individuals often are faced with many critical life decisions, including health care and housing choices, investment of retirement income, and allocation of personal wealth. 

 

"By simply identifying a person as potentially vulnerable to fraud, family members can be more vigilant and can implement measures to protect the older adult," Denburg said. "In addition, a conservator or family member could be involved in transactions involving large amounts of money."

 

Denburg's most recent study, published in the Annals of the New York Academy of Sciences, shows that 35 to 40 percent of a test group of 80 healthy older adults with no apparent neurological deficits have poor decision-making abilities as tested in a laboratory experiment known as the Iowa Gambling Task (IGT). The IGT is a computerized decision-making test where participants draw cards from different decks with the aim of maximizing their winnings. Some of the decks yield good results in aggregate, while others yield poor outcomes.

 

Following the poor decision-makers through several additional tests, the researchers found that in addition to the poor performance on the IGT, this subgroup of older adults also were more likely to fall prey to deceptive advertising.

 

Using a set of real advertisements that had been deemed misleading by the Federal Trade Commission and several counterpart, non-deceptive advertisements, the study showed that the poor decision-makers are much less able to spot inconsistencies and pick up on deceptive messages than good decision-makers. Poor decision-makers also were more likely to indicate an intention to buy the article advertised in the misleading advertisement. In contrast, there was no difference in comprehension of non-deceptive advertisements between the two groups of older adults.

 

The researchers also measured the amount of palm sweating for each participant as they performed the Iowa Gambling Task. Bodily (or autonomic) responses, like sweating, have been shown to play an important role in decision-making. When these responses are absent or abnormal, then decision-making also is affected.

 

Good decision-makers display different anticipatory responses (amount of sweating) prior to a good or a bad choice, which appears to help them discriminate between the two options. In contrast, the older adults with poor decision-making abilities did not sweat more or less when deciding between a good or bad choice.

 

Another group of patients who perform poorly on the IGT and have abnormal bodily responses to the test are individuals with acquired damage to the ventromedial prefrontal cortex (VMPC) — an area of the brain that appears to be critical for good decision-making.

 

"Our hypothesis is that older poor decision-makers have deficits in their prefrontal cortex," Denburg explained. "The next element of our study will be to complete structural and functional brain-imaging studies to see if we can identify differences between poor decision-makers and good decision-makers either in brain structure or in how the brain functions during decision-making tasks."

 

The team already is conducting structural imaging tests, and Denburg has just received a three-year, $100,00 grant from the Dana Foundation to do functional imaging studies.

 

Preliminary analysis of the structural imaging data suggests there are physical differences between the brains of poor decision-makers and those of the good decision-makers.

 

Understanding the neurological basis for impaired decision-making could also suggest potential medications that might help. Some studies have suggested that altering neurotransmitter levels may affect decision-making ability. However, Denburg notes that this approach is speculative at this time.

 

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The current study was funded by a grant from the National Institute on Aging.

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Natalie Denburg, Ph.D., is an assistant professor of neurology in the Carver College of Medicine at the University of Iowa. The Research team included Michael Hernandez, a UI neurosciences graduate student, and Torricia Yamada, a UI counseling psychology graduate student; Daniel Tranel, Ph.D., UI professor of neurology and psychology; Antoine Bechara, Ph.D., associate professor of psychology and neuroscience at the University of Southern California and UI adjunct associate professor of neurology; Catherine Cole, Ph.D., professor and head of marketing in the UI Henry B. Tippie College of Business; and Robert Wallace, M.D., professor of epidemiology in the UI College of Public Health.

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The orbitofrontal cortex, real-world decision making, and normal aging. Denburg NL, Cole CA, Hernandez M, Yamada TH, Tranel D, Bechara A, Wallace RB. Ann. N.Y. Acad. Sci. 1121: 480–498 (2007). doi: 10.1196/annals.1401.031.

 

Abstract. The present series of three studies aims at investigating the hypothesis that some seemingly normal older persons have deficits in reasoning and decision making due to dysfunction in a neural system which includes the ventromedial prefrontal cortices. This hypothesis is relevant to the comprehensive study of aging, and also addresses the question of why so many older adults fall prey to fraud. To our knowledge, this work represents the first of its kind to begin to identify, from an individual-differences perspective, the behavioral, psychophysiological, and consumer correlates of defective decision making among healthy older adults. Our findings, in a cross-sectional sample of community-dwelling participants, demonstrate that a sizeable subset of older adults (approximately 35-40%) perform disadvantageously on a laboratory measure of decision making that closely mimics everyday life, by the manner in which it factors in reward, punishment, risk, and ambiguity. These same poor decision makers display defective autonomic responses (or somatic markers), reminiscent of that previously established in patients with acquired prefrontal lesions. Finally, we present data demonstrating that poor decision makers are more likely to fall prey to deceptive advertising, suggesting compromise of real-world judgment and decision-making abilities.

 

 

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