Preliminary Acceptability and Efficacy of an Expected Value Decision-Making Training Intervention among Older and Younger Adults: A Pilot Study

Effective decision-making is critical to successful aging as many high-stakes medical and financial decisions must be made as one ages, yet decision-making quality often declines with age. This pilot study evaluated the feasibility, acceptability, and preliminary efficacy of an Expected Value (EV) maximization training designed to optimize risky decision-making performance in older adults. A two-week longitudinal pilot study was conducted with healthy older (n=30) and younger (n=35) adults. Participants completed a risky choice task at baseline, immediate follow-up, and two-week follow-up. EV maximization training entailed a didactic video plus a hands-on repeated choice training task with feedback. Feasibility was supported among older adults (0% attrition) but limited in younger adults (39% attrition). Acceptability ratings exceeded expectations (≥75% positive) and were significantly higher in older than younger adults. Older adults’ performance improved from 45% accuracy at baseline to 84% at immediate posttest and 75% at two-week follow-up, whereas younger adults showed no benefit. EV maximization training was feasible, well-accepted, and showed evidence of preliminary efficacy in older adults.