Age-related differences in medication risk taking

Abstract

Prior studies on older adults’ risk taking have paid little attention to the healthcare domain. The current study examined age-related differences in medication risk taking. Participants were 36 English speaking younger adults (55.6% females) between the ages of 19 and 26 (M = 20.94, SD = 1.55), and 35 English speaking older adults (60.0% females) between the ages of 67 and 80 (M = 72.34, SD = 3.09). We asked them to choose between hypothetical medications that differed in probabilities and outcomes of treatment success. To investigate the effects of risk-disadvantageous versus risk-neutral versus risk-advantageous situations, participants chose between a risky option and a sure option that had a higher expected value (risk-disadvantageous), between a risky option and a sure option that had equal expected values (risk-neutral), and between a risky option and a sure option that had a lower expected value (risk-advantageous). Overall, older adults were more risk averse. Older adults also showed a smaller increase in risk-taking tendency across risk-disadvantageous, risk-neutral, and risk-advantageous situations compared to younger adults, consistent with the idea that younger adults are more likely to use verbatim processing than older adults in making decisions (Peters et al., 2007; Reyna & Brainerd, 2011). Further examination of individual participant’s medication risky choices revealed that younger and older adults could be essentially classified into three groups: younger adults who were sensitive to expected value differences between options, older adults who took fewer risks than did younger adults but were sensitive to expected value differences, and older adults who were extremely risk averse and exhibited no sensitivity to expected value differences (54.29% of the older adult sample). Post-hoc exploratory analyses found that a variety of individual difference measures (i.e., education, perceived health, numeracy, health literacy, global cognitive ability, perceived severity of sickness) did not differentiate sensitive and insensitive older adults. This could indicate that other variables should be considered as an explanation for the large inter-individual variability in sensitivity among older adults. These findings emphasize the importance of designing decision aids to encourage older adults to take more (fewer) risks when risk taking is more (less) beneficial, and point to the need for improving the communication of outcome and probability information in medication risky decisions to older adults.