No abstract

Introduction: Making advantageous decisions is a key competence of individuals of all ages. However, previous studies reported a reduction of this competence in patients with neurodegenerative diseases such as Alzheimer's disease, which is explained by impairments of executive functions such as cognitive flexibility or working memory. While previous findings from healthy participants with reduced executive functions showed that support can improve decision making under risk, the study at hand aimed to investigate this effect in patients with mild Alzheimer's disease (mAD). Method: A group of elderly individuals diagnosed with mAD (n = 14; mean MMSE = 24.14, SD = 3.18) and a control group of healthy age-matched controls (n = 14; mean MMSE = 29.29, SD = 1.98) performed a decision-making task (GDT) three times (t0, t1, t2) with intervals of five to nine days between each: The standard GDT plus other neurocognitive tasks (t0), the GDT with supportive information following each decision (t1), and again the GDT without decision support (t2). Results: At any time, mAD patients made more disadvantageous decisions than controls. However, the decision-making performance of mAD patients improved significantly with decision support. Interestingly, when the standard GDT was played again (t2), mAD patients' performance remained similar to the performance in the GDT with decision support (t1). GDT performance correlated consistently with executive function measures in the control group, but only at t0 in the mAD group. Conclusions: The findings indicate that supportive information about the riskiness of options can compensate for mAD-related deficits in decision making under risk. Thus, decision support can improve the quality of mAD patients' decisions. Further, it may prevent mAD patients from making highly risky decisions in similar situations in the future. The persistence of decision support should be further investigated as it has relevant implications for everyday decisions that include risks.

The uncontrolled use of specific Internet applications is increasingly recognized as a mental health issue. Gaming disorder, which is one subtype of specific Internet-use disorders (sIUDs), has been included in the ICD-11 as disorder due to addictive behaviors. Addictive disorders are assumed to be accompanied by cognitive deficits as indicated by weaker performance in executive function and risky decision-making tasks. This study investigates risky decision-making in individuals with tendencies towards sIUDs including gaming, online buying-shopping, and social-networks-use disorders. A total of 293 individuals participated in the study. Based on specific screening instruments, the participants were assigned to a group with tendencies towards sIUD or a control group. Participants completed a risky decision-making task and questionnaires assessing risk-taking propensity, impulsivity, psychopathology, and perceived stress. The group with sIUD tendencies showed higher attentional impulsivity and higher levels of depression and anxiety compared to the control group. The groups did not differ in decision making and risk propensity. Decision making did not have significant effects on sIUD symptoms. Risk for developing sIUDs does not appear to be accompanied by altered general decision-making tendencies. Rather, psychological (pre-)load and attentional deficits appear to be relevant features in uncontrolled use of the Internet.