Reduced future-oriented decision making in individuals with subjective cognitive decline: A functional MRI study

INTRODUCTION Subjective cognitive decline (SCD) refers to an at-risk state of Alzheimer's disease and subtle cognitive deficits that have been observed in this condition. Currently, it is unknown whether complex cognitive processes relevant to everyday life, such as future-oriented choice behavior, are also altered in SCD. METHODS Twenty SCD participants and 24 control (CO) participants took part in a functional magnetic resonance imaging task on intertemporal decisions, with and without simultaneous episodic future imagination. RESULTS SCD participants showed reduced future-oriented choices. Future imagination increased future-oriented choices and was associated with increased brain activation in medial frontal polar cortex, right insular cortex, and anterior cingulate cortex in CO only, not SCD. In addition, more future-oriented choices were associated with hippocampal activation during choice processing in CO only. DISCUSSION Subtle neuronal network disruptions in SCD may underlie their myopic future decisions and lack of modulation of choice behavior by episodic future imagination.