Multifaceted Declines in Everyday Decision-Making in Older Adults: A Think-Aloud Study

BackgroundExperimental evidence has shown sensory and cognitive changes in old age can affect everyday decision-making. Environmental supports may play an important role in mitigating negative impacts.ObjectiveThis study aimed to (a) identify challenges older adults face in everyday decision-making, (b) assess how environmental supports influence decision-making performance, and (c) explore strategies older adults use to support everyday decision-making.MethodsTwenty-six older adults in the UK participated in think-aloud interviews while performing decision-making tasks under varied visual clarity and note-taking conditions. Follow-up discussions probed everyday decision-making challenges and supports.Results'Comprehension' and 'process' challenges were most frequent. Clearer presentation improved overall performance, with fewer reading challenges. Note-taking reduced calculation challenges but increased comprehension challenges, making no difference to overall performance. Support strategies used in everyday life included note-taking, and sensory and social support. Findings indicate decision-making declines in older adults are multifaceted, shaped by sensory, cognitive, and socio-emotional factors.