{"id":{"repo_id":"vt","oai_identifier":"oai:vtechworks.lib.vt.edu:10919/134254"},"canonical_url":"https://search.dev.ndltd.org/etd/vt/oai:vtechworks.lib.vt.edu:10919/134254","repository":{"repo_id":"vt","name":"Virginia Tech","base_url":"https://vtechworks.lib.vt.edu/oai/request"},"display":{"title":"Executive Functioning Markers of Functional Decline and Health Vulnerability in Older Adults: The Role of Temporal Discounting","abstract":"Temporal discounting (TD), a behavioral economic index of the tendency to devalue rewards or outcomes as delay to their receipt increases, captures future-oriented decision-making, self-control, and reward valuation. However, despite the well-documented predictive utility of TD in a variety of maladaptive health behaviors, psychopathology, and functional outcomes, the clinical utility of TD is understudied in neuropsychology, particularly in older adults at risk of or experiencing cognitive decline. This dissertation examined the role of TD in identifying early cognitive and behavioral vulnerability among older adults, with a focus on its utility relative to traditional executive functioning (EF) neuropsychological assessments. Specifically, in Study 1, TD was evaluated alongside standard EF measures to examine associations with functional status in instrumental activities of daily living (IADLs; e.g. cooking, managing finances) among individuals with and without mild cognitive impairment (MCI). Results showed that TD, in combination with working memory, significantly predicted IADL functioning but did not differentiate diagnostic status (i.e., MCI compared to normal cognition). TD also appeared to capture a distinct facet of EF, as it was not significantly correlated with other EF tasks. In Study 2, the relationship between TD, EF, and cumulative vulnerability burden (i.e., having multiple socioeconomic, behavioral, and health-related risk factors) was investigated. TD emerged as the sole cognitive correlate of high vulnerability status. Together, findings suggest that TD may reflect a shared neurobehavioral mechanism underlying both functional decline and health disparities in older adults. Overall, this research supports the integration of behavioral economic constructs in aging research and clinical assessment to improve early detection, intervention, and prognoses.","abstract_html":"Temporal discounting (TD), a behavioral economic index of the tendency to devalue rewards or outcomes as delay to their receipt increases, captures future-oriented decision-making, self-control, and reward valuation. However, despite the well-documented predictive utility of TD in a variety of maladaptive health behaviors, psychopathology, and functional outcomes, the clinical utility of TD is understudied in neuropsychology, particularly in older adults at risk of or experiencing cognitive decline. This dissertation examined the role of TD in identifying early cognitive and behavioral vulnerability among older adults, with a focus on its utility relative to traditional executive functioning (EF) neuropsychological assessments. Specifically, in Study 1, TD was evaluated alongside standard EF measures to examine associations with functional status in instrumental activities of daily living (IADLs; e.g. cooking, managing finances) among individuals with and without mild cognitive impairment (MCI). Results showed that TD, in combination with working memory, significantly predicted IADL functioning but did not differentiate diagnostic status (i.e., MCI compared to normal cognition). TD also appeared to capture a distinct facet of EF, as it was not significantly correlated with other EF tasks. In Study 2, the relationship between TD, EF, and cumulative vulnerability burden (i.e., having multiple socioeconomic, behavioral, and health-related risk factors) was investigated. TD emerged as the sole cognitive correlate of high vulnerability status. Together, findings suggest that TD may reflect a shared neurobehavioral mechanism underlying both functional decline and health disparities in older adults. Overall, this research supports the integration of behavioral economic constructs in aging research and clinical assessment to improve early detection, intervention, and prognoses.","abstract_has_math":false,"creators":["Craft, Candice Laurel"],"institution":"Virginia Tech","degree_name":"Doctor of Philosophy","degree_level":"doctoral","degree_discipline":"Psychology","degree_department":"Psychology","school":null,"contributors":[],"advisors":[],"committee_chairs":["Kim-Spoon, Jungmeen","Stein, Jeffrey S."],"committee_members":["Davis, Heather Avese","Brem, Meagan Jacquelyn","Sollinger, Ann Bryan"],"year":2025,"date_issued":"2025-05-27","date_published":"2025-05-27","updated_at":"2026-07-22T22:20:27Z","subjects":["Temporal discounting","behavioral economics","executive functioning","mild cognitive impairment","cumulative vulnerability","health disparities","functional decline"],"languages":["en"],"rights":["In Copyright"],"rights_urls":["http://rightsstatements.org/vocab/InC/1.0/"],"identifier_entries":[{"key":"dc:identifier.other","label":"Dc Identifier Other","values":["vt_gsexam:44057"],"render_values":[{"text":"vt_gsexam:44057","href":null,"code":true}]}]},"links":{"outbound_url":"https://hdl.handle.net/10919/134254","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.committeechair","label":"Committee Chair","values":["Kim-Spoon, Jungmeen","Stein, Jeffrey S."]},{"key":"dc:contributor.committeemember","label":"Committee Member","values":["Davis, Heather Avese","Brem, Meagan Jacquelyn","Sollinger, Ann Bryan"]},{"key":"dc:contributor.department","label":"Department","values":["Psychology"]},{"key":"dc:creator","label":"Author","values":["Craft, Candice Laurel"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2025-05-28T08:03:02Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2025-05-28T08:03:02Z"]},{"key":"dc:date.issued","label":"Date","values":["2025-05-27"]},{"key":"dc:publisher","label":"Institution","values":["Virginia Tech"]},{"key":"dc:type","label":"Dc Type","values":["Dissertation"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Psychology"]},{"key":"thesis:degree_level","label":"Degree Level","values":["doctoral"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Doctor of Philosophy"]},{"key":"thesis:institution_name","label":"Thesis Institution Name","values":["Virginia Polytechnic Institute and State University"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Temporal discounting","behavioral economics","executive functioning","mild cognitive impairment","cumulative vulnerability","health disparities","functional decline"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language.iso","label":"Language (ISO)","values":["en"]},{"key":"dc:rights","label":"Dc Rights","values":["In Copyright"]},{"key":"dc:rights.uri","label":"Rights URI","values":["http://rightsstatements.org/vocab/InC/1.0/"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.other","label":"Dc Identifier Other","values":["vt_gsexam:44057"]},{"key":"dc:identifier.uri","label":"Identifier URI","values":["https://hdl.handle.net/10919/134254"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Temporal discounting (TD), a behavioral economic index of the tendency to devalue rewards or outcomes as delay to their receipt increases, captures future-oriented decision-making, self-control, and reward valuation. However, despite the well-documented predictive utility of TD in a variety of maladaptive health behaviors, psychopathology, and functional outcomes, the clinical utility of TD is understudied in neuropsychology, particularly in older adults at risk of or experiencing cognitive decline. This dissertation examined the role of TD in identifying early cognitive and behavioral vulnerability among older adults, with a focus on its utility relative to traditional executive functioning (EF) neuropsychological assessments. Specifically, in Study 1, TD was evaluated alongside standard EF measures to examine associations with functional status in instrumental activities of daily living (IADLs; e.g. cooking, managing finances) among individuals with and without mild cognitive impairment (MCI). Results showed that TD, in combination with working memory, significantly predicted IADL functioning but did not differentiate diagnostic status (i.e., MCI compared to normal cognition). TD also appeared to capture a distinct facet of EF, as it was not significantly correlated with other EF tasks. In Study 2, the relationship between TD, EF, and cumulative vulnerability burden (i.e., having multiple socioeconomic, behavioral, and health-related risk factors) was investigated. TD emerged as the sole cognitive correlate of high vulnerability status. Together, findings suggest that TD may reflect a shared neurobehavioral mechanism underlying both functional decline and health disparities in older adults. Overall, this research supports the integration of behavioral economic constructs in aging research and clinical assessment to improve early detection, intervention, and prognoses."]},{"key":"dc:description.abstractgeneral","label":"General Abstract","values":["As people age, they can face challenges with thinking abilities including but not limited to planning, organization, problem-solving, and decision-making. These cognitive difficulties can render everyday activities (e.g., grocery shopping, managing medications and finances) challenging. This research studied how older adults make choices about the future - specifically, how much they value smaller, immediately available rewards (i.e., hypothetical amounts of money) over larger, delayed rewards. This type of decision-making, called temporal discounting (TD), has been linked to a variety of health issues and risky behaviors. However, TD has not been widely studied in older adults, especially those at risk for cognitive decline. Across two studies, older adults completed tests of executive functioning (EF) and shared information about their daily functioning, lifestyle, and health. In Study 1, people who had more difficulty with everyday tasks were more likely to show patterns of decision-making that favored immediate over delayed rewards. This tendency was not picked up by more traditional tests of EF. In Study 2, the same decision-making pattern was strongly linked to having multiple life challenges, such as low socioeconomic status, mental health symptoms including depression, and maladaptive health behaviors, including hazardous drinking, cigarette smoking, as well as poor nutrition and sedentary lifestyles. Together, the findings suggest that how someone makes choices about the future may be an early warning sign of both cognitive decline and broader health risks. This research highlights the value of using financial decision-making patterns to better identify and support older adults who may be experiencing cognitive and functional decline."]},{"key":"dc:description.degree","label":"Dc Description Degree","values":["Doctor of Philosophy"]},{"key":"dc:format.medium","label":"Dc Format Medium","values":["ETD"]},{"key":"dc:title","label":"Title","values":["Executive Functioning Markers of Functional Decline and Health Vulnerability in Older Adults: The Role of Temporal Discounting"]}]}],"canonical_facts":{"dc:contributor.committeechair":["Kim-Spoon, Jungmeen","Stein, Jeffrey S."],"dc:contributor.committeemember":["Davis, Heather Avese","Brem, Meagan Jacquelyn","Sollinger, Ann Bryan"],"dc:contributor.department":["Psychology"],"dc:creator":["Craft, Candice Laurel"],"dc:date.accessioned":["2025-05-28T08:03:02Z"],"dc:date.available":["2025-05-28T08:03:02Z"],"dc:date.issued":["2025-05-27"],"dc:description.abstract":["Temporal discounting (TD), a behavioral economic index of the tendency to devalue rewards or outcomes as delay to their receipt increases, captures future-oriented decision-making, self-control, and reward valuation. However, despite the well-documented predictive utility of TD in a variety of maladaptive health behaviors, psychopathology, and functional outcomes, the clinical utility of TD is understudied in neuropsychology, particularly in older adults at risk of or experiencing cognitive decline. This dissertation examined the role of TD in identifying early cognitive and behavioral vulnerability among older adults, with a focus on its utility relative to traditional executive functioning (EF) neuropsychological assessments. Specifically, in Study 1, TD was evaluated alongside standard EF measures to examine associations with functional status in instrumental activities of daily living (IADLs; e.g. cooking, managing finances) among individuals with and without mild cognitive impairment (MCI). Results showed that TD, in combination with working memory, significantly predicted IADL functioning but did not differentiate diagnostic status (i.e., MCI compared to normal cognition). TD also appeared to capture a distinct facet of EF, as it was not significantly correlated with other EF tasks. In Study 2, the relationship between TD, EF, and cumulative vulnerability burden (i.e., having multiple socioeconomic, behavioral, and health-related risk factors) was investigated. TD emerged as the sole cognitive correlate of high vulnerability status. Together, findings suggest that TD may reflect a shared neurobehavioral mechanism underlying both functional decline and health disparities in older adults. Overall, this research supports the integration of behavioral economic constructs in aging research and clinical assessment to improve early detection, intervention, and prognoses."],"dc:description.abstractgeneral":["As people age, they can face challenges with thinking abilities including but not limited to planning, organization, problem-solving, and decision-making. These cognitive difficulties can render everyday activities (e.g., grocery shopping, managing medications and finances) challenging. This research studied how older adults make choices about the future - specifically, how much they value smaller, immediately available rewards (i.e., hypothetical amounts of money) over larger, delayed rewards. This type of decision-making, called temporal discounting (TD), has been linked to a variety of health issues and risky behaviors. However, TD has not been widely studied in older adults, especially those at risk for cognitive decline. Across two studies, older adults completed tests of executive functioning (EF) and shared information about their daily functioning, lifestyle, and health. In Study 1, people who had more difficulty with everyday tasks were more likely to show patterns of decision-making that favored immediate over delayed rewards. This tendency was not picked up by more traditional tests of EF. In Study 2, the same decision-making pattern was strongly linked to having multiple life challenges, such as low socioeconomic status, mental health symptoms including depression, and maladaptive health behaviors, including hazardous drinking, cigarette smoking, as well as poor nutrition and sedentary lifestyles. Together, the findings suggest that how someone makes choices about the future may be an early warning sign of both cognitive decline and broader health risks. This research highlights the value of using financial decision-making patterns to better identify and support older adults who may be experiencing cognitive and functional decline."],"dc:description.degree":["Doctor of Philosophy"],"dc:format.medium":["ETD"],"dc:identifier.other":["vt_gsexam:44057"],"dc:identifier.uri":["https://hdl.handle.net/10919/134254"],"dc:language.iso":["en"],"dc:publisher":["Virginia Tech"],"dc:rights":["In Copyright"],"dc:rights.uri":["http://rightsstatements.org/vocab/InC/1.0/"],"dc:subject":["Temporal discounting","behavioral economics","executive functioning","mild cognitive impairment","cumulative vulnerability","health disparities","functional decline"],"dc:title":["Executive Functioning Markers of Functional Decline and Health Vulnerability in Older Adults: The Role of Temporal Discounting"],"dc:type":["Dissertation"],"thesis:degree_discipline":["Psychology"],"thesis:degree_level":["doctoral"],"thesis:degree_name":["Doctor of Philosophy"],"thesis:institution_name":["Virginia Polytechnic Institute and State University"]},"updated_at":"2026-07-22T22:20:27Z"}