ArticleCureus2025
Ecological Factors Influencing Decision-Making Among Middle-Aged and Older Adults: A Neurocognitive Approach.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionDecision-making capacity (DMC) significantly influences the autonomy and well-being of middle-aged and older adults. While extensive research has addressed cognitive determinants of decision-making, less attention has been given to ecological factors, especially within non-Western contexts. This study aims to assess ecological influences (social environment, emotional states, stress levels) on decision-making competence among the older population in Pakistan, employing a neurocognitive approach to address gaps in culturally diverse research.
methodsA quantitative cross-sectional study was conducted from September to October 2024, involving 100 adults aged ≥45 years from Rawalpindi and Islamabad. Participants completed a structured questionnaire incorporating demographic information, the Adult Decision-Making Competence (A-DMC) scale, the Satisfaction with Life Scale (SWLS), the Geriatric Depression Scale (GDS), and assessments of ecological and cognitive factors. Data was analyzed using IBM SPSS Version 26 (IBM Corp., Armonk, NY), employing descriptive statistics, correlations, independent sample t-tests, ANOVA, and regression analyses.
resultsMarital status and living arrangements significantly influenced social environment perceptions (p = 0.03), stress levels (p = 0.05), and cognitive engagement (p = 0.01). Married individuals reported better social environments and lower stress than single participants. Individuals living with family showed higher subjective well-being (M=19.61±4.53) compared to those living alone (M=17.33±7.09) or with friends (M=13.20±6.69; F=4.65, p<0.01). Age groups showed non-significant trends in decision-making scores, with seniors (65+ years) scoring lower (M=33.75±20.33) compared to pre-seniors (M=45.21±14.05) and middle-aged adults (M=44.35±13.33; p=0.06). Regression analysis indicated minimal predictive value of social environment, ecological context, and physical environment for decision-making competence (R²=0.014, p=0.711).
conclusionThe findings underscore the significant roles of marital status and living contexts in shaping psychological well-being, social interactions, and stress in middle-aged and older adults. Decision-making appears less directly influenced by ecological contexts, indicating potential resilience due to life experience. Future research should employ longitudinal designs and broader samples to enhance understanding and generalizability.
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