Emotion and Non-cognitive Measures of Decision-making Ability in Older Adults Within ARMCADA: A Pilot Study

Elizabeth M. Dworak1, Y. Catherine Han1, Sarah Pila1, Emily H. Ho1, Berivan Ece1, Tatiana Karpouzian-Rogers2, Shahin Davoudpour1, Patricia Bucko1, David Cella1, Sandra Weintraub2,3, and Richard C. Gershon1 
1Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 2Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 3Mesulam Institute for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL  

Brief, easily administered emotional and non-cognitive measures can help identify personality and individuals with greater financial vulnerability and subjective cognitive concerns, highlighting their promise as early indicators of cognitive decline and dementia-related risk. 

INTRODUCTION

As the U.S. population ages, the burden of Alzheimer's disease and related dementias (AD/ADRD) continues to grow.1,2
Early detection of abnormal cognitive decline is no longer optional, it is essential.
An abnormal decline in decision-making (DM) ability may serve as an early sign of abnormal cognitive decline.3
Emotional and non-cognitive (ENC) factors shape DM by influencing risk perception, judgement, and choice preferences.4-6
The ARMCADA (Advancing Reliable Measurement in Cognitive Aging and Decision-making Ability) project identified ENC measures with high potential to be included in a multidomain DM battery for adults (45+).

METHODS

This pilot study included 152 adults over 40 (61.8% participants aged 60 and above; 59.9% female) from the general population located across rural (20.4%), suburban (57.9%), and urban (20.4%) regions in the United States.

Participants completed measures assessing ENC (Table 1) along with self-reported measures of subjective cognitive decline (SCD)
Everyday Cognition Scale (ECog-12)7
Memory Complaint Scale (MCS)8

Table 1. ENC Measures used in Pilot

ENC Measures
Construct
Items
Response Options
Adjustable Impulsivity Scale9 (AIMS)
Impulsivity, 
Risk-Taking
50
5 (Strongly disagree – Strongly agree)
Gullibility Scale10,11
Gullibility
12
5 (Strongly disagree – Strongly agree)
Reading the Mind in the Eyes Test12 (RMET)
Theory of Mind,  Social Inference
36
4 (Different words)
Ten-Item Personality Inventory13 (TIPI)
Personality
10
7 (Disagree strongly – Agree strongly)
Mild Behavioral Impairment Checklist14 (MBI-C)
Neuropsychiatric Symptoms
34
2 (Yes / No) 
3 (Mild / Moderate / Severe)
PROMIS Depression15
Depression
4
5 (Never – Always)
PROMIS Anxiety15
Anxiety
4
5 (Never – Always)
PROMIS Social Isolation15
Social Isolation
4
5 (Never – Always)

Pilot Research Questions
RQ1: Are the selected ENC measures feasible and reliable?
RQ2: How do ENC measures relate to each other?
RQ3: How do ENC measures relate to self-reported SCD?

 

RESULTS

Feasibility: >95% completion; ~15min for total ENC battery

Reliability: Most measures α/KR-20>.80 (TIPI scales α = [.35, .80])
MBI-C domains related to
each other (generally rs≥.20)
greater anxiety, depression, and social isolation (rs≥.60)
greater SCD (rs≥.34)

Higher impulsivity related to
higher overall gullibility (r=.53)
higher MBI-C (r=.35)
greater anxiety, depression, and social isolation (rs≥.27)
greater SCD (MCS: r=.37; ECog-12: r=.55)

Higher emotional stability related to
lower impulsivity (r=-.47)
lower anxiety, depression, and social isolation (rs≤-.52)
lower SCD (MCS: r=-.35; ECog-12: r=-.41)

Higher conscientiousness related to
lower impulsivity (r=-.52)
lower overall gullibility (r=-.51)
lower SCD (MCS: r=-.22; ECog-12: r=-.46)

 

Figure 1. Relationship between ENC measures

Figure 2. ENC relation with SCD measures

 

REFERENCES

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CONCLUSIONS

Findings support the feasibility of administering the selected ENC measures in adults over 40.
This pilot lays the groundwork for examining interactions between ENC factors and DM, and for identifying measures and items most predictive of abnormal trajectories of DM.
Future work will validate the battery across a broad spectrum of cognitive decline

CONTACT

This work is supported by NIA grant #1U24AG082022. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

For more information, please contact Dr. Elizabeth Dworak at
elizabeth.dworak@northwestern.edu