Dorien Bangma

50 | CHAPTER 3 Discussion The objective of this explorative study was to determine the effects of normal aging on different aspects of FDM. Based on previously published procedures in the field of (medical) decision- making, a comprehensive test battery was developed reflecting eight aspects of FDM. It was expected that some more cognitive demanding aspects of FDM were negatively influenced by normal aging due to age-related cognitive decline (Braver &West, 2008; Denburg & Hedgcock, 2015; Salthouse, 1996; Salthouse & Meinz, 1995), while other aspects remained relatively stable or even improved due to an age-related increase of knowledge and experience or an improved affective decision-making in older adults (Hess, 2015; Li et al., 2004; Mikels et al., 2013; Peters et al., 2007). When looking at the different aspects of FDM, no effects of normal aging were found on relatively basic aspects of FDM, i.e., financial competence and (financial) decision-making capacity. These results suggest that the (mental) ability or capacity and knowledge to perform actions that are needed to execute financial transactions on a relatively basic level are relatively stable across the adult life span. Furthermore, no or only relatively weak associations were found between financial competence, (financial) decision-making capacity and measures of cognition, suggesting that financial competence and (financial) decision-making capacity are not related to performances on measures of cognition. However, it is also possible that an age- related improvement in affective processing and an increased knowledge and experience with regard to these relatively basic aspects of FDM compensate for an age-related decline in cognition (Mather & Knight, 2005; Meyer et al., 1995). This hypothesis cannot be evaluated on the basis of the present data and therefore needs further investigation. Interestingly, most studies that examined the capacity to make decisions within a medical context, e.g., about different treatment options, among patients with mental disorders (Grisso & Appelbaum, 1995; Hindmarch et al., 2013), medical disorders (Karlawish et al., 2013; Martin, Okonkwo, et al., 2008) or elderly with and without cognitive impairments (Kim et al., 2001; Vellinga et al., 2005), suggest that a poorer decision-making capacity is related to cognitive dysfunctioning. None of the studies, however, examined the effects of normal aging on the capacity to make decisions by using a life-span perspective. Furthermore, so far, only two studies focused on decision making capacity in a financial context and found that patients with mild cognitive impairments or Alzheimer’s disease (Lui et al., 2013) and patients with intellectual disabilities (Suto et al., 2005) have more difficulties with financial decision-making capacity compared to a healthy comparison group. Also the FCAI, measuring financial competence, has been shown to be able to distinguish individuals with cognitive impairments from individuals without cognitive impairments (Kershaw & Webber, 2008). These studies suggest that financial competence and (financial) decision-making capacity are sensitive to more severe cognitive dysfunctions and, therefore, might be impaired in patients with, e.g., mild cognitive impairments or Alzheimer’s disease. In the present study, however, no evidence for effects of normal aging on these relatively basic aspects of FDM were found. Also regarding the use of decision-making styles in FDM situations no significant effects of normal aging were found. To our knowledge, the present study is the first study investigating