RF1AG030611

LITCOG V: HEALTH LITERACY AND COGNITIVE FUNCTION AMONG OLDER ADULTS - WE SEEK TO RENEW OUR LONGSTANDING COHORT STUDY, KNOWN AS `LITCOG' (R01AG030611), AND CULMINATE INVESTIGATIONS OF COGNITIVE FUNCTION TRAJECTORIES AMONG OLDER ADULTS AND THEIR INVOLVED CAREGIVERS. SINCE 2007, THE LITCOG STUDY HAS EXAMINED THE CONFLUENCE OF INCREASED MEDICAL MORBIDITY WITH OLDER AGE THAT RESULTS IN MORE COMPLEX PATIENT SELF-MANAGEMENT (SM) ROLES, AND COGNITIVE DECLINE THAT MAY ADVERSELY AFFECT OLDER ADULTS' HEALTH LITERACY (HL) SKILLS, CHRONIC ILLNESS SELF-CARE, AND FUNCTIONAL INDEPENDENCE. INITIALLY A CROSS- SECTIONAL STUDY (LITCOG I), ADULTS AGES 55-74 WERE RECRUITED FROM COMMUNITY-BASED, PRIMARY CARE PRACTICES THROUGHOUT CHICAGO. PARTICIPANTS COMPLETED COMPREHENSIVE COGNITIVE, PSYCHOLOGICAL, SOCIAL, BEHAVIORAL, AND FUNCTIONAL HEALTH ASSESSMENTS (`T1' INTERVIEW). LITCOG BECAME A COHORT STUDY WITH 3 RENEWAL AWARDS (LITCOG II, III, IV); FOLLOW-UP ASSESSMENTS HAVE BEEN CONDUCTED EVERY 3 YEARS (T2-T6). OUR RESEARCH HAS SHOWN HOW COGNITIVE FUNCTION DETERMINES ONE'S HL, THAT BOTH DECLINE TOGETHER OVER TIME, AND DECLINES IN CERTAIN COGNITIVE DOMAINS ADVERSELY IMPACT SM SKILLS, TREATMENT ADHERENCE, FUNCTIONAL HEALTH STATUS, AND CHRONIC DISEASE OUTCOMES. MODIFIABLE PSYCHOLOGICAL, BEHAVIORAL, AND SOCIAL RISK FACTORS FOR COGNITIVE DECLINE HAVE BEEN IDENTIFIED. INITIATED BY AN ADMINISTRATIVE SUPPLEMENT AND EXPANDED IN THIS FUNDING CYCLE (LITCOG IV), A `LITCOG CAREGIVER' COHORT IS NOW ESTABLISHED; 3 CAREGIVER INTERVIEWS (ALIGNED TO T4-T6) HAVE EXAMINED THE PRESENCE, SKILLS, AND EVOLVING SUPPORT PROVIDED BY CAREGIVERS, AND WHETHER / HOW THEIR INVOLVEMENT HAS BENEFITED LITCOG PARTICIPANTS. WE NOW SEEK A LITCOG V RENEWAL THAT WILL ADD A T7, T8 ASSESSMENT AND 2 ADDITIONAL CAREGIVER INTERVIEWS. AFTER 15 YEARS, PATIENT AND CAREGIVER PARTICIPANTS REMAIN AVAILABLE FOR FURTHER STUDY. WITH 8 PATIENT ASSESSMENTS OVER 2 DECADES, WE ARE WELL-POISED TO ASSESS THE PREVALENCE OF AND ADJUSTMENT TO INCREASING MORBIDITY, DISABILITY, COGNITIVE IMPAIRMENT (CI), AND DEMENTIA. TRAJECTORIES OF COGNITIVE FUNCTION, HL, SM SKILLS, HEALTH BEHAVIORS, PHYSICAL/MENTAL HEALTH, CLINICAL OUTCOMES, HEALTHCARE USE AND MORTALITY CAN BE BETTER MODELED. WITH 5 PARALLEL CAREGIVER INTERVIEWS OVER 12 YEARS, CAREGIVER DETERMINANTS OF PATIENT HEALTH OUTCOMES CAN BE MORE PRECISELY INVESTIGATED. COSTS OF COGNITIVE DECLINE, CI AND DEMENTIA WILL ALSO BE EXPLORED, RESPONDING TO NIA PRIORITIES. OUR SPECIFIC AIMS ARE TO: 1) FINALIZE INVESTIGATIONS OF TRAJECTORIES OF COGNITIVE FUNCTION, HL, AND SM SKILLS, AND THEIR DETERMINANTS, OVER A 20-YEAR SPAN AMONG OLDER ADULTS; 2) DETERMINE THE PREVALENCE OF CI AND DEMENTIA AND IDENTIFY FACTORS ASSOCIATED WITH ITS DETECTION, DIAGNOSIS, AND ONGOING MANAGEMENT; 3) INVESTIGATE HEALTH MANAGEMENT SUPPORT ROLES AMONG CAREGIVERS OVER 12 YEARS; 4) ESTIMATE THE DIRECT AND INDIRECT COSTS OF COGNITIVE DECLINE, COGNITIVE IMPAIRMENT, AND DEMENTIA FROM A LOCAL PATIENT, CAREGIVER, AND HEALTH SYSTEM PERSPECTIVE. LITCOG V WILL BE A CAPSTONE TO OUR INVESTIGATIONS INTO AGE-RELATED COGNITIVE CHANGES WITH INCREASING COMORBIDITY, AND MODIFIABLE FACTORS THAT MAY OFFSET THE IMPACT OF COGNITIVE DECLINE ON HEALTH OUTCOMES.

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]

Illinois United States

State-Wide

NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed) (PA-20-185)