The ability to decide advantageously declines prematurely in some normal older persons

The prefrontal region of the brain, including the ventromedial sector which supports reasoning and decision-making, may undergo disproportionate aging in some older persons, but the empirical evidence is decidedly mixed. To help resolve this, we tested 80 neurologically and psychiatrically healthy Younger (aged 26-55) and Older (aged 56-85) adults on a "Gambling Task", which provides a close analog to real-world decision-making by factoring in reward, punishment, and unpredictability, yielding a sensitive index of ventromedial prefrontal function. A subset of the Older group manifested a decision-making impairment on the Gambling Task, in spite of otherwise intact cognitive functioning. This finding raises the possibility of disproportionate aging of the ventromedial prefrontal cortex in these individuals. Our finding has important societal and public policy implications (e.g., choosing medical care, allocating personal wealth), and may also help explain why many older individuals are targeted by and susceptible to fraudulent advertising. (c) 2004 Elsevier Ltd. All rights reserved.