Aging and decision-making competence: An analysis of comprehension and consistency skills in older versus younger adults considering health-plan options

Older adults need to maintain strong decision-making capabilities as they age. However, we know little about how age-related physical and psychological changes affect older adults' judgement and decision processes. This paper reports the results of research comparing older versus younger adults' performance on evaluation and choice tasks about health-plan options. In particular, comprehension and consistency in judgments (across separate versus joint evaluation contexts) were examined. Results indicated that increasing age was related to greater comprehension errors and inconsistent preferences, even when covariates (education, income, gender, self-perceived skill and health, decision style, and attitude toward delegation) were taken into account. Discussion of the results emphasizes difficulties in interpreting the meaning of age differences in performance on decision tasks and the need for research that ascertains the seriousness of the consequences of age differences in real-life tasks. The implications for providing decision-aiding interventions for older adults are highlighted. Copyright (C) 2002 John Wiley Sons, Ltd.