Framing Effects in Older Adults' Medical Decision-Making: Social Distance Matters

The present study sought to explore how decision making is influenced by aging, framing, and social distance in the medical domain. Based on Socioemotional Selectivity Theory, we predicted that social distance would moderate age differences of framing effects as a result of older adults' emphasis on close partners. Younger and middle-aged (N = 206) and older (N = 208) adults from Shanghai, China completed 2 medical decision tasks in which they were presented with different descriptions of social distance, namely deciding for close relatives or for strangers. Participants' risk preferences were measured. The results showed that framing effects were a function of social distance in older adults. Older adults showed smaller framing effects when making decisions for strangers as their preference for the riskier option was reduced in the loss-framed condition. For younger and middle-aged adults, framing effects existed consistently regardless of social distance. These findings suggest that social distance moderates age differences in framing effects in medical decision-making. It also highlights a potential way to improve older adults' medical decision-making quality: having older adults imagine as if they are making medical decisions for a stranger.