Decision-making in Cognitively Unimpaired Illiterate and Low-educated Older Women: Results on the Iowa Gambling Task

Objective: This study investigated the pattern of decision-making (DM) on the Iowa Gambling Task (IGT) in a sample of Portuguese speaking healthy older women in Brazil with limited education: illiterate, 1-2 years, and 3-4 years of schooling.

Methods: Around 164 non-demented community-dwelling women participated in the study. Among them 60 were illiterate, 52 had 1-2 years of schooling and 52 had 3-4 years of schooling. Participants completed the instruments: Brief Cognitive Screening Battery (BCSB), Mini-Mental State Examination, Verbal Fluency Test (animal category), Clock Drawing Test, Geriatric Depression Scale, Geriatric Anxiety Inventory, Digit Span Forward and Backward, Raven's Coloured Progressive Matrices, Wisconsin Card Sorting Test, and IGT.

Results: The three education groups were equivalent as to age, number of diseases, medications taken daily, depression, and anxiety symptoms. In the IGT the literate older adults made more advantageous choices than the illiterate and IGT performance improved linearly with higher levels of education. IGT performance correlated significantly with all cognitive test scores with the exception of the memorization of the pictures on the BCSB.

Conclusion: The results suggested that education influences IGT performance, with worse scores among the illiterate. Results may be used by clinicians to interpret IGT performance among seniors with low literacy levels.