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A generic brain connectome map linked to different types of everyday decision-making in old age.

ABSTRACT: Making reasonable decisions related to financial and health scenarios is a crucial capacity that can be difficult for older adults to maintain as they age, yet few studies examine neurocognitive factors that are generalizable to different types of everyday decision-making capacity. Here we propose an innovative approach, based on individual risk-taking preference, to identify neural profiles that may help predict older adults' everyday decision-making capacity. Using performance and cognitive arousal information from two gambling tasks, we identified three decision-making preference groups: ambiguity problem-solvers (A), risk-seekers (R), and a control group without strong risk-taking preferences (C). Comparisons of the number of connections within white matter tracts between A vs. C and R vs. C groups resulted in features consistent with the theory of dual neural functional systems involved in decision-making. Unique tracts from the A vs. C contrast were primarily centered in dorsal frontal regions/reflective system; unique tracts from the R vs. C contrast were centered in the ventral frontal regions/impulsive system; and shared tracts from both contrasts were centered in the basal ganglia, coordinating the switch between the two types of decision-making preference. Number of connections from the tracts differentiating A vs. C significantly predicted financial and health/safety decision-making capacity, and the association remained significant after controlling for multiple socioeconomic and cognitive factors. The connectome identified may provide insight into a generic white matter mechanism related to everyday decision-making capacity in older age.

SUBMITTER: Rooks B

PROVIDER: S-EPMC7274871 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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A generic brain connectome map linked to different types of everyday decision-making in old age.

Rooks Brian B Anthony Mia M Chen Quanjing Q Lin Ying Y Baran Timothy T Zhang Zhengwu Z Lichtenberg Peter A PA Lin Feng F

Brain structure & function 20191219 4

Making reasonable decisions related to financial and health scenarios is a crucial capacity that can be difficult for older adults to maintain as they age, yet few studies examine neurocognitive factors that are generalizable to different types of everyday decision-making capacity. Here we propose an innovative approach, based on individual risk-taking preference, to identify neural profiles that may help predict older adults' everyday decision-making capacity. Using performance and cognitive ar ...[more]

PMID: 31858236

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Project description:BackgroundShared decision making (SDM) is a core element in the meeting between patient and healthcare professionals, but has proved difficult to implement and sustain in routine clinical practice. One of five Danish regions set out to succeed and to develop a model that ensures lasting SDM based on learnings from large-scale real-world implementation initiatives that go beyond the 'barriers' and 'facilitators' research approach. This paper describes this process and development of a generic implementation model, SDM:HOSP.MethodsThis project was carried out in the Region of Southern Denmark with five major hospital units. Based on existing theory of SDM, SDM implementation, implementation science and improvement methodology, a process of four phases were described; development of conceptual elements, field-testing, evaluation, and development of the final implementation model. The conceptual elements developed aimed to prepare leaders, train SDM teachers, teach clinicians to perform SDM, support development of patient decision aids, and support systematic planning, execution and follow-up. Field testing was done including continuous participant evaluations and an overall evaluation after one year.ResultsData from field testing and learnings from the implementation process, illustrated the need for a dynamic and easy adjustable model. The final SDM:HOSP model included four themes; i)Training of Leaders, ii) Training of Teachers and Clinicians, iii) Decision Helper, and iv) 'Process', each with details in three levels, 1) shared elements, 2) recommendations, and 3) local adaption.ConclusionsA feasible and acceptable model for implementation of SDM across hospitals and departments that accounts for different organizations and cultures was developed. The overall design can easily be adapted to other organizations and can be adjusted to fit the specific organization and culture. The results from the ongoing and overall evaluation suggest promising avenues for future work in further testing and research of the usability of the model.

Dataset Information

A generic brain connectome map linked to different types of everyday decision-making in old age.

Publications

A generic brain connectome map linked to different types of everyday decision-making in old age.

Similar Datasets

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