R01AG070212

Health Literacy and Cognitive Function Among Middle-Aged Adults: The MIDCOG Study

We will expand our active study of older adults and recruit a parallel cohort of middle-aged adults to begin novel investigations of less-studied, modifiable, midlife determinants of later life cognitive impairment. Studying cognitive changes in middle adulthood (ages 40-64) could elucidate modifiable factors that might prevent later life cognitive impairment. Very few cognitive aging studies to date include this age group. Those that have are limited to small or condition-specific samples, cross-sectional analyses, or cohort studies with few follow-up periods, abbreviated cognitive tests, limited covariates, or a lack of diversity in study samples.

But many known factors for cognitive impairment manifest in middle age: 1) chronic conditions that often are delayed in their detection or inadequately managed due to poor treatment adherence; 2) undetected or uncorrected sensory impairments; 3) entrenched lifestyle behaviors; and 4) common biological and psychosocial stressors. Thus, greater attention is being paid to proper health self-management and routine healthcare engagement in midlife.

Yet many U.S. adults may reach middle age lacking proficient health literacy; the capacity to gather accurate self-care knowledge, make informed health decisions, enact recommended behaviors, and appropriately use health services. Health literacy is modifiable by enhancing health knowledge and self-care skills, but also by reducing treatment burden imparted by health systems. Promoting health literacy could improve self-management, increase routine healthcare use, and modify lifestyle, thus reducing the risk of later life impairment.

Since 2007, we have examined how cognitive decline affects health literacy, self-management skills, and health (R01AG030611) among older adults. Our active "LITCOG" study has shown how cognitive function affects health literacy, self-management, and health in older age. But in midlife, limited health literacy and self-management skills may lead to unhealthy lifestyle, chronic disease, and poorly managed health due to infrequent healthcare use and poor treatment adherence, increasing the risk of cognitive impairment.

Our 2020 LITCOG renewal adds a 5th and 6th follow-up interview. We seek to initiate a parallel, middle-aged cohort ("MIDCOG"; ages 40-64; N=1200), conducting the first two assessments 2.5 years apart. Our specific aims are to:

1) Characterize health literacy, self-management skills, and cognitive function in detail among middle-aged adults;
2) Evaluate associations between health literacy, self-management skills, health behaviors, healthcare use, health status, chronic disease outcomes, and cognitive function over time;
3) Investigate whether certain modifiable, psychosocial, midlife factors moderate associations between health literacy, self-management skills, health status, and cognition; and
4) Using MIDCOG + LITCOG data, explore associations between age, health literacy, self-management skills, health status, presence and management of chronic disease, and cognitive function among adults ages 40 to 90.

We will complement existing midlife research and inform health system strategies to preserve cognitive function.

Northwestern University

TO ENCOURAGE BIOMEDICAL, SOCIAL, AND BEHAVIORAL RESEARCH AND RESEARCH TRAINING DIRECTED TOWARD GREATER UNDERSTANDING OF THE AGING PROCESS AND THE DISEASES, SPECIAL PROBLEMS, AND NEEDS OF PEOPLE AS THEY AGE. THE NATIONAL INSTITUTE ON AGING HAS ESTABLISHED PROGRAMS TO PURSUE THESE GOALS. THE DIVISION OF AGING BIOLOGY EMPHASIZES UNDERSTANDING THE BASIC BIOLOGICAL PROCESSES OF AGING. THE DIVISION OF GERIATRICS AND CLINICAL GERONTOLOGY SUPPORTS RESEARCH TO IMPROVE THE ABILITIES OF HEALTH CARE PRACTITIONERS TO RESPOND TO THE DISEASES AND OTHER CLINICAL PROBLEMS OF OLDER PEOPLE. THE DIVISION OF BEHAVIORAL AND SOCIAL RESEARCH SUPPORTS RESEARCH THAT WILL LEAD TO GREATER UNDERSTANDING OF THE SOCIAL, CULTURAL, ECONOMIC AND PSYCHOLOGICAL FACTORS THAT AFFECT BOTH THE PROCESS OF GROWING OLD AND THE PLACE OF OLDER PEOPLE IN SOCIETY. THE DIVISION OF NEUROSCIENCE FOSTERS RESEARCH CONCERNED WITH THE AGE-RELATED CHANGES IN THE NERVOUS SYSTEM AS WELL AS THE RELATED SENSORY, PERCEPTUAL, AND COGNITIVE PROCESSES ASSOCIATED WITH AGING AND HAS A SPECIAL EMPHASIS ON ALZHEIMER'S DISEASE. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM: TO EXPAND AND IMPROVE THE SBIR PROGRAM, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, TO INCREASE SMALL BUSINESS PARTICIPATION IN FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION. SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM: TO STIMULATE AND FOSTER SCIENTIFIC AND TECHNOLOGICAL INNOVATION THROUGH COOPERATIVE RESEARCH DEVELOPMENT CARRIED OUT BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO FOSTER TECHNOLOGY TRANSFER BETWEEN SMALL BUSINESS CONCERNS AND RESEARCH INSTITUTIONS, TO INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT, AND TO FOSTER AND ENCOURAGE PARTICIPATION OF SOCIALLY AND ECONOMICALLY DISADVANTAGED SMALL BUSINESS CONCERNS AND WOMEN-OWNED SMALL BUSINESS CONCERNS IN TECHNOLOGICAL INNOVATION.

93.866 - Aging Research

National Institute on Aging (NIA) [HHS - NIH]

Chicago, Illinois 60611 United States

Single Zip Code

Self-Management for Health in Chronic Conditions (R01 Clinical Trial Optional) (PA-18-376)

Amendment Since initial award the total obligations have increased 363% from $815,886 to $3,775,148.