The present series of three studies aims at investigating the hypothesis that some seemingly normal older persons have deficits in reasoning and decision making due to dysfunction in a neural system which includes the ventromedial prefrontal cortices. This hypothesis is relevant to the comprehensive study of aging, and also addresses the question of why so many older adults fall prey to fraud. To our knowledge, this work represents the first of its kind to begin to identify, from an individual-differences perspective, the behavioral, psychophysiological, and consumer correlates of defective decision making among healthy older adults. Our findings, in a cross-sectional sample of community-dwelling participants, demonstrate that a sizeable subset of older adults (approximately 35-40%) perform disadvantageously on a laboratory measure of decision making that closely mimics everyday life, by the manner in which it factors in reward, punishment, risk, and ambiguity. These same poor decision makers display defective autonomic responses (or somatic markers), reminiscent of that previously established in patients with acquired prefrontal lesions. Finally, we present data demonstrating that poor decision makers are more likely to fall prey to deceptive advertising, suggesting compromise of real-world judgment and decision-making abilities.

Background A well-studied index of reasoning and decision making is the Iowa Gambling Task (IGT). The IGT possesses many features important to medical decision making, such as weighing risks and benefits, dealing with unknown outcomes, and making decisions under uncertainty. Purpose There exists a great deal of individual variability on the IGT, particularly among older adults, and the present study examines the role of personality in IGT performance. We explored which of the five-factor model of personality traits were predictive of decision-making performance, after controlling for relevant demographic variables. Methods One hundred and fifty-two healthy cognitively intact adults (aged 26–85) were individually administered the IGT and the NEO Five-Factory Inventory. Results In the older adults, but not the younger, higher NEO neuroticism was associated with poorer IGT performance. Conclusions Our findings are discussed in the context of how stress may impact cognitive performance and cause dysfunction of neural systems in the brain important for decision making.

The present study examined the long-term cognitive implications of cancer treatment among breast cancer survivors aged 65 years and older. Fifty-seven women survivors were compared to 30 healthy older female adult comparisons, matched in terms of age and education, with no history of cancer. Cancer survivors were also compared based on treatment intervention, involving chemotherapy (n = 27) versus local therapy through surgery and radiation (n = 30). As a group, the breast cancer survivors scored lower on measures of general cognitive function, working memory, psychomotor speed, and executive function, when compared to the normal comparisons. Among the cancer survivors, those who received local therapy scored lower than the other survivors and normal comparisons on measures of verbal learning, visual perception and construction, as well as visual attention and short-term retention. Our findings suggest that cognitive outcomes may involve more age-related deficits among older cancer survivors compared to matched healthy subjects.

Religious discrimination in the workplace has received little attention in the research. The present study is an exploratory study that investigated the impact of workplace discrimination on a self‐selected sample of diverse Muslim women living across the United States (N = 129). The results of this study revealed that workplace discrimination, job stress, social class, and religiosity were related to lower levels of job satisfaction. Implications of the results are discussed in terms of clinical intervention strategies.

Purpose The term “chemobrain” is sometimes used to denote deficits in neuropsychological functioning that may occur as a result of cancer treatment. As breast cancer survivors now commonly reach late life, it is not known whether previous exposure to chemotherapy may affect long-term risk for cognitive impairment. To help address this concern, this study tested whether successfully surviving chemotherapy earlier in life was associated with later differences in brain metabolic function as an older adult compared to controls. This question was examined using PET measures of brain glucose metabolism in elderly women cancer survivors. Methods Breast cancer survivors (N=10), currently free of recurrent cancer and without a diagnosis of a cognitive disorder, were compared to matched healthy controls (N=10). All subjects were imaged at rest with [18F]fluorodeoxyglucose (FDG). Images were analyzed semi-quantitatively using the Alzheimer's Discrimination Tool (PMOD) and a VOI-based approach derived from co-registered MRIs. Results Relative FDG uptake (normalized to global) was significantly lower in the survivors compared to control subjects in bilateral orbital frontal regions, consistent with differences between the groups in cognition and executive function (i.e., TMT-B, MMSE) and despite no significant differences with respect to age, education, intelligence, or working memory. None of the survivors and only one control manifested a global PET score consistent with an Alzheimer's Disease (AD) metabolic pattern. Conclusion Breast cancer survivors treated with chemotherapy may manifest long-term changes in brain glucose metabolism indicative of subtle frontal hypometabolism, a finding consistent with results from neuropsychological testing and other imaging modalities.