Risk Aversion and Alzheimer Disease in Old Age
Robert S Wilson1, Lei Yu2, Julie A Schneider3
1Rush Alzheimer's Disease Center and Departments of Neurological Sciences, (RSW, LY, JAS, DAB); Behavioral Sciences (RSW, PAB).
Summary
Increased risk aversion in older adults may signal early dementia, specifically Alzheimer's disease pathology. This finding suggests risk aversion could be a prodromal sign, appearing before cognitive decline is evident.
Area of Science:
- Neuroscience
- Gerontology
- Behavioral Economics
Background:
- Late-life risk aversion is a behavioral trait that may change with aging.
- Identifying early indicators of dementia is crucial for timely intervention.
- Alzheimer's disease is characterized by specific neuropathological changes.
Purpose of the Study:
- To investigate whether increased risk aversion in older adults is an early indicator (prodromal sign) of dementia.
- To explore the association between risk aversion and the incidence and progression of cognitive impairment, including mild cognitive impairment (MCI) and dementia.
- To examine the relationship between risk aversion and neuropathological markers of Alzheimer's disease.
Main Methods:
- A longitudinal clinical-pathologic cohort study involving 874 older adults without dementia.
- Risk aversion assessed at baseline using choice-based questions.
- Annual cognitive evaluations for MCI and dementia diagnosis, with neuropathologic examination post-mortem.
Main Results:
- Higher risk aversion was linked to a significantly increased incidence of dementia and MCI.
- Increased risk aversion correlated with faster decline in episodic and semantic memory.
- Neuropathological analysis revealed associations between higher risk aversion and increased levels of plaques, tangles, and cerebral amyloid angiopathy.
Conclusions:
- The findings support the hypothesis that heightened risk aversion in late life is an early sign of Alzheimer's disease pathology.
- Risk aversion may serve as a preclinical or prodromal marker for Alzheimer's disease.
- This behavioral change warrants further investigation as a potential diagnostic or prognostic indicator.
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