How Does Decision
Making Change As We Age?
The human brain's ability to process information
declines with age, but knowledge about the world through experiences
tends to rise over time. So how do these shifts affect a person's
ability to make sound decisions?
It turns out that it depends on the situation. In some decisions,
thinking harder about unfamiliar information will produce the best
decisions, and older adults are likely to fare less well, says Ellen
Peters, courtesy professor of psychology at the University of Oregon
and senior research scientist with Decision Research. But in other
situations, she said, people make better choices when they rely
on emotions and past experiences, and older adults may excel in
More research is needed to understand how decisions differ across
the lifespan so that better advice can be tailored to older adults,
Peters said. "We know quite a bit about how the brain processes
information, but we don't know a whole lot about how that is going
to interact in decisions with experiences and emotional prompts,"
Peters is co-author of a paper in which she and colleagues examine
existing literature about the aging brain and decision making.
Little is known about this important topic at a time when Americans
are looking at a fast-growing elderly population, she and colleagues
write in the quarterly journal Perspectives on Psychological Science
(Volume 2, Issue 1). By 2050, they note, there will be more people
older than 65 than those younger than 15 for the first time in
"Having a high quality of life requires good decisions,
yet we know next to nothing about age differences in decision
making," Peters said. "For many elderly individuals,
the ability to function independently is a particular concern.
By understanding when the elderly make decisions as well as or
better than young adults and when their decisions are compromised
by declining cognitive abilities, policymakers, family and friends
can better target situations in which assistance is more necessary
and other situations where it is not needed."
The review article looked at basic information processes and
mechanisms that have been studied around the world, using a dual-process
approach. One process involves how people think their way through
information; the other focuses on how they feel their way through
"There were robust differences in these systems," Peters
said. "Thinking capacity declines with time. We learn less
easily. We process information more slowly." However, from
the emotional side of processing, "We may show improvements
over time. We may tend to feel our way through decisions more
when we are older."
While that improvement may exist, older people who respond emotionally
may be more prone to becoming victims of scam artists, who often
play on emotion, Peters said.
An emerging idea, she added, is that an older person's motivation
may change from the forward-looking vision of a young person to
one that prioritizes feeling good in the moment. She noted a just-published
study in the journal Psychology and Aging by Corinna E. Löckenhoff
and Laura L. Carstensen of Stanford University that found that
older people focus more on positive benefits than on negative
risks in making health choices.
Understanding the effects of these processes is vital to improving
aging people's decision-making, Peters said. "Older people
who make mistakes have less time and less physical resiliency
to compensate for bad decisions than do younger people,"
she said. "Older people are more vulnerable. We may not be
able to teach an old dog new tricks, but the old dog may have
lots and lots of old tricks that help quite a bit. In some situations,
the old dogs may be making better decisions than the pups."
Peters began looking at this topic while studying how the presentation
of information impacts medical decisions by older people, particularly
issues involving Medicare and prescription drug options. In one
study, participants were asked to pick the lowest co-payment among
four insurance policies. A simple chart showed the plans, monthly
premiums and co-payments, but more than 40 percent of 80-84 year
olds failed to choose $5 from options ranging from $5
With aging people being faced with major decisions affecting
their ability to live independently, including finances and retirement,
medical treatments, when to quit driving and what food to eat,
understanding age differences in how information is processed
in decisions has important theoretical and pragmatic implications,
Peters said. "Dealing with numbers, for example, is an area
in which older adults require more assistance," she said.
In a separate study, published in the April issue of the journal
Medical Care Research and Review, Peters and another group of
scientists concluded that "less is more" in the presentation
of numbers portraying medical information. In three studies, 303
employment-aged adults from 18 to 64 years old weighed various
amounts and formats of information about hospital treatments.
Simple presentations dramatically helped people with lower number-processing
skills understand more and make higher quality decisions. Researchers
also found that the use of symbols sometimes helped people make
decisions and other times hindered them.
Co-authors with Peters on the study in Perspectives in Psychological
Science were Thomas M. Hess of North Carolina State University,
Daniel Västfjäll of Decision Research and Goteborg University
in Sweden and Corinne Auman of Presbyterian College in South Carolina.
The report was supported by the National Science Foundation, the
National Institutes of Health and the NIH National Institute on
Co-authors with Peters on the study appearing in Medical Care
Research and Review were: Nathan Dieckmann, a graduate teaching
fellow at the University of Oregon and researcher at Decision
Research; Anna Dixon, lecturer in European Health Policy at the
London School of Economics and former visiting scholar in the
UO Institute for Policy Research and Innovation; Judith H. Hibbard,
professor of planning, public policy & management at the UO;
and C.K. Mertz of Decision Research. The study was funded by the
Blue Cross Blue Shield Association and the National Science Foundation.