Flip a coin? Roll the dice? Consult an expert? How do you decide?
What happens as we age that may either compromise or strengthen our decision-making capacities? To appreciate how aging affects our ability to make decisions, we need to first understand age-related changes in basic psychological processes involved, including social, cognitive and emotional motivations for decisions. Research providing that knowledge can help us build better interventions to support decision making by older adults including decisions that affect their health.
Many adults must make complex decisions about things that most people would rather not think about. Advancing years bring about important challenges, such as managing short- and long-term illnesses and health conditions and planning for end-of-life care. Financial decisions include making a will and designating power of attorney for financial, legal, and health issues, as well as the planning needed to ensure that we can maintain our health and well-being as we grow older. Longer life expectancy requires that we maintain good decision making abilities into our later years, to handle increasingly difficult issues related to health care and independent living.
Financial vulnerability is a particular worry for many families. Financial exploitation is the most prevalent form of elder mistreatment in this country, possibly because of decision-making deficits that make older people especially vulnerable. Cognitive impairment associated with Alzheimer’s disease (AD) and related dementias can intensify this risk.
An opportunity to learn more
Recently, in September 2016, NIA released two program announcements with special review (PARs) on decision making and aging. One PAR will support R01 awards in Basic and Translational Research on Decision Making in Aging and Alzheimer's Disease. The other PAR will support R21 awards in this area. For the first year of funding, NIA has a special set-aside of $2.75 million across the two announcements. We hope to fund up to three to five R01s and three to four R21s in the first year.
The next deadline for applications responding to these announcements is June 1.
We welcome projects focused on normal aging, as well as those aimed at AD and related dementias. Compromised psychological abilities in mild cognitive impairment and in AD may make people especially vulnerable to exploitation and abuse. Research on decision making in the early stages of AD may help us better recognize the signs and symptoms of disordered decision making and to help us know when best to intervene.
Two types of research will be funded
We’re looking for applications that address both basic and translational research in decision making. Proposals are invited which span approaches from psychology, behavioral economics, neuroscience, behavioral medicine, and allied fields:
- Basic research includes: characterizing the extent to which basic behavioral and neural processes involved in decision making are affected in normal aging and AD; research on the influence of social factors on decision-making, particularly decisions about health; and research on factors that render older adults with and without AD vulnerable to financial exploitation and other forms of mistreatment and abuse.
- Translational research opportunities include: development of interventions to leverage individuals’ strengths to help them make decisions across the lifecycle; development of tools to assess decisional capacity; strategies for simplifying choices and offering better defaults for health and treatment-related decisions for midlife and older adults with and without AD; and increasing our understanding of the best time for delegation practices, such as power of attorney, living wills, and advance health and financial directives.
Again, the next deadline for applications under these PARs is in June. I hope you’ll decide now to submit an application.