Purpose in Life and Cognition Interact to Impact Healthcare and Financial Decision Making in Old Age

Abstract

Objectives: Little is known about the contribution of positive psychological factors, such as purpose in life, to healthcare and financial decision making in aging. Here, we examined the relationship between purpose and decision making and tested the hypothesis that purpose benefits decision making, particularly when cognition is limited. Methods: Participants were 1081 community-based older adults without dementia. Healthcare and financial decision making was measured via a 12-item performance-based instrument. Purpose was measured via a 10-item scale. Results: In a linear regression model adjusted for age, sex, and education, higher global cognition was associated with better performance on the decision making measure, as expected. Purpose was not directly related to decision making. However, the interaction of purpose with cognition was significant, such that greater purpose was associated with better decision making among persons with lower cognition. Discussion: Purpose in life may promote better decision making among older adults with lower cognition.

Psychological Well-being Relates to Healthcare and Financial Decision Making in a Study of Predominantly White Older Adults

“…The current findings also extend our emerging work demonstrating that positive psychological resources play a critical role in decision making among older adults with diminished cognitive abilities (Glover et al, 2021;Stewart et al, 2020;Stewart et al, 2022). For example, we reported that more frequent engagement in cognitive activity-a positive psychological resource-was associated with better decision making, particularly among older adults with lower levels of cognitive function (Glover et al, 2021).…”

“…For example, we have found that risk aversion is associated with decision making independent of cognition, but loneliness interacts with cognition to affect decision making (Boyle et al, 2012a; Stewart et al, 2020). Notably, in our work, the effects of psychological and experiential factors were most prominent among older adults with lower cognition (Glover et al, 2021; Stewart et al, 2020; Stewart et al, 2022).…”

“…Most previous research has focused on negative psychological attributes, and relatively little is known about the associations between positive psychological constructs and decision making (Denburg et al, 2009;Gautam & Mathur, 2018;Kang et al, 2019;Lichtenberg et al, 2016Lichtenberg et al, , 2020Nguyen et al, 2013). One exception is our recent finding that purpose in life-a positive psychological construct that refers to one's sense of meaning and investment in life experiences-is associated with better decision making among older adults, especially those with poorer cognitive function (Stewart et al, 2022). Purpose in life, however, is only one component of the larger construct of psychological well-being, which refers to one's broader sense that life is good and marked by active and meaningful engagement and positive interactions with others.…”