The Association of Late Life Cognitive Activity with Healthcare and Financial Decision-Making in Community-Dwelling, Nondemented Older Adults

Am J Geriatr Psychiatry. 2021 Feb;29(2):117-125. doi: 10.1016/j.jagp.2020.06.010. Epub 2020 Jun 16.


Objective: The purpose of this study was to test the hypothesis that late life cognitive activity is associated with decision-making in older adults and to examine whether this association varies by level of cognitive function.

Design: This study employed a cross-sectional design.

Setting: All data were collected in participants' community-based residences.

Participants: Participants were 1,084 older adults (mean age = 81.05 years, standard deviation = 7.53) without dementia (median Mini-Mental State Examination score = 29, interquartile range = 27.86-30.00).

Measurements: Participants completed assessments of late life cognitive activity, cognitive function, and decision-making. We used linear regression models to examine the associations of late life cognitive activity and cognitive function with decision-making.

Results: In a regression model adjusted for age, gender, and education, more frequent late life cognitive activity was associated with better decision-making, as was higher cognitive function. Furthermore, in an additional model that included the interaction of late life cognitive activity and cognitive function, the interaction was significant, such that late life cognitive activity was most strongly associated with decision-making among participants with lower levels of cognitive function.

Conclusion: Frequent engagement in late life cognitive activity may help maintain decision-making among older persons, particularly among those with lower levels of cognitive function.

Keywords: Older adults; cognitive aging; decision-making; late life cognitive activity.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aging / psychology*
  • Cognition*
  • Cross-Sectional Studies
  • Decision Making*
  • Delivery of Health Care*
  • Female
  • Financial Management*
  • Humans
  • Independent Living*
  • Male