Racial Differences in Decision Making among Older Adults
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PROJECT SUMMARY/ABSTRACT Decision making in financial and health matters is of critical importance for maintaining independence and wellbeing in old age, and recent work in predominately older White adults suggests decision making worsens with age. While there is a paucity of knowledge regarding decision making in older Black adults, preliminary studies suggest there may be differences in decision making by race. Decision making can be viewed as a complex interaction of externally influenced contextual factors with two internal systems: a cognitive processing system and an affective processing system. Although racial differences in cognitive processing have been well documented, little is known about racial differences in other components of decision making, and these could have profound economic and public health consequences for a diverse range of older adults. The overall goal of this study is to elucidate racial differences in decision making among older adults and to identify the contextual factors, affective factors, and neurobiological mechanisms that drive them. Contextual factors, such as acquired financial and health literacy, socioeconomic status (SES), and perceived discrimination, vary by race, are often influenced by adverse social and environmental experiences over the life course, and could have important mediating effects between race and decision making. Life course experiences also shape internally modulated affective processes. Since differences in decision making are observed when affective processes interact with cognitive processes, affective factors such as trust, risk aversion, and loneliness could have important moderating effects on decision making by race. Both contextual and affective factors have recently been shown to impact the functional architecture of brain networks, revealing important insights into the neural systems involved in decision making. Regrettably, these findings have been almost exclusively in White persons; thus there is a dearth of knowledge regarding the neural correlates of decision making in Black persons. Racial differences in contextual and affective factors experienced over the life course may result in variability in the organization of functional brain systems. However, it is unknown how or whether any putative differences in functional neural network architecture may drive racial differences in decision making. Finally, Black adults are at greater risk for Alzheimer's disease (AD). Our recent work has implicated poor decision making as a potential risk factor for AD in White adults; however, it is unknown whether and to what extent poor decision making is a risk for AD in Black adults. The proposed study will leverage existing clinical data from nondemented older Blacks and Whites participating in the Minority Aging Research Study (RF1AG022018), the Rush Clinical Core (P3010161), and an ongoing study of decision making in aging (R01AG033678) to collect new behavioral decision making and neuroimaging data among older Black adults. Knowledge of racial differences in decision making and the associated factors that drive them will provide crucial information for identifying potentially modifiable targets for intervention to address health disparities.
