Decision-making competence (DMC) appears to be influenced by the congruency between the characteristics of the individual, the task and the context. Indeed, the ability to make decisions seems to be highly sensitive to cognitive changes as observed, in particular, in the healthy elderly. Few studies have investigated these relations in pathological ageing. In this review, we focus on DMC in patients with Alzheimer’s disease (AD) and the links its impairment could have with deficits in episodic memory, working memory, and executive functions. Decision-making under risk and under ambiguity appears to be impaired early in the progress of AD, with the deficit being greater during the later stages of the disease. In addition, some studies suggest that the impairment of DMC is exacerbated by deficits in other cognitive functions, in particular working memory and executive functions. This degradation in the ability to make decisions seriously affects the quality of life of patients and their relatives, since they frequently face important decisions, especially concerning healthcare, finance or accommodation. Thus, the growing incapacity to decide for themselves increases patients’ and caregivers’ stress and burden. The challenge for future studies is to determine how best to help patients and their families in the decisional process.

决策能力 (DMC) 似乎受到个人特征、任务和环境之间一致性的影响。事实上，做出决定的能力似乎对观察到的认知变化高度敏感，特别是在健康老年人中。很少有研究调查这些与病理性衰老的关系。在这篇综述中，我们关注阿尔茨海默病 (AD) 患者的 DMC 及其受损可能与情景记忆、工作记忆和执行功能缺陷之间的联系。在 AD 的早期，在风险和模棱两可的情况下做出的决策似乎受到了损害，在疾病的后期阶段这种缺陷更大。此外，一些研究表明，其他认知功能的缺陷会加剧 DMC 的损害，特别是工作记忆和执行功能。这种决策能力的下降严重影响了患者及其亲属的生活质量，因为他们经常面临重要的决定，尤其是在医疗保健、财务或住宿方面。因此，越来越无能力自行决定增加了患者和护理人员的压力和负担。未来研究的挑战是确定如何在决策过程中最好地帮助患者及其家人。越来越无能力自行决定增加了患者和护理人员的压力和负担。未来研究的挑战是确定如何在决策过程中最好地帮助患者及其家人。越来越无能力自行决定增加了患者和护理人员的压力和负担。未来研究的挑战是确定如何在决策过程中最好地帮助患者及其家人。