Health Literacy and Cognitive Function among Middle-Aged Adults: The MidCog Study

中年人的健康素养和认知功能：MidCog 研究

基本信息

批准号：
10626062
负责人：
MICHAEL S WOLF
金额：
$ 74.62万
依托单位：
NORTHWESTERN UNIVERSITY AT CHICAGO
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-08-15 至 2026-04-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10626062
关键词：
Abbreviations Adult Affect Age Alcohol consumption Alzheimer&apos s disease related dementia Anxiety Attention Automobile Driving Behavior Behavioral Biological Caring Chronic Chronic Disease Clinical Cognition Cognitive Cognitive aging Cohort Studies Complement Cross-Sectional Studies Data Depressed mood Detection Diabetes Mellitus Disease Outcome Economics Education Elderly Electronic Health Record Family Health Health Promotion Health Status Health behavior Health system Healthcare Hearing Heavy Drinking Hospitalization Hyperlipidemia Hypertension Impaired cognition Impairment Individual Interview Investigation Knowledge Life Style Longitudinal cohort Mediating Medical Memory Mental Depression Methods Obesity Outcome Participant Perimenopause Pharmaceutical Preparations Pharmacy facility Psychosocial Factor Public Health Recommendation Reporting Research Risk Risk Behaviors Risk Factors Risk Reduction Role Sampling Sampling Studies Self Care Self Management Sensory Site Smoke Smoking Social support Socioeconomic Status Stress Surveys Thinking Time Uncertainty Unhealthy Diet Vision Woman Work age group anxious caregiving cognitive change cognitive function cognitive testing cohort comorbidity dementia risk follow-up health assessment health knowledge health literacy health management health service use human old age (65+)improved low health literacy middle age mortality risk multiple chronic conditions novel physical inactivity poor health outcome poor sleep preservation prevent psychologic psychosocial psychosocial stressors racial diversity recruit skills social treatment adherence unhealthy lifestyle uptake

项目摘要

We will expand our active study of older adults and recruit a parallel cohort of middle age 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 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 risk of cognitive impairment. Our 2020 LitCog renewal adds a 5th, 6th follow-up interview. We seek to initiate a parallel, middle age 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 age 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 & management of chronic disease, and cognitive function among adults ages 40 to 90. We will complement existing midlife research & inform health system strategies to preserve cognitive function.

我们将扩大对老年人的积极研究，并招募一组平行的中年成年人来开始对研究较少、可改变的中年晚年认知障碍决定因素的新颖研究。研究成年中期（40-64 岁）的认知变化可以阐明可改变的因素预防晚年认知障碍。迄今为止，很少有认知衰老研究涵盖这个年龄段。那些仅限于小样本或针对具体情况的样本、横断面分析或队列研究，几乎没有随访期、简化的认知测试、有限的协变量或研究样本缺乏多样性。但许多已知的认知障碍因素在中年时表现出来：1）慢性疾病通常会延迟未能及时发现，或因治疗依从性差而管理不善； 2) 未被发现或未被纠正感觉障碍； 3）根深蒂固的生活方式； 4) 常见的生物和社会心理压力源。因此，人们更加关注适当的健康自我管理和日常医疗保健参与中年。然而，许多美国成年人可能在人到中年时仍缺乏熟练的“健康素养”。聚集能力准确的自我保健知识，做出明智的健康决定，制定推荐的行为和适当利用卫生服务。通过增强健康知识和自我保健，可以改变健康素养技能，还可以减轻卫生系统造成的治疗负担。提高健康素养可以改善自我管理，增加日常医疗保健的使用并改变生活方式；从而降低晚年生活受损的风险。自 2007 年以来，我们研究了认知能力下降如何影响健康素养、自我管理技能和健康 (R01AG030611) 老年人。我们积极的“LitCog”研究表明认知功能如何影响健康识字、自我管理和老年健康。但人到中年，健康素养和自我管理能力有限由于缺乏频繁的医疗保健，技能可能会导致不健康的生活方式、慢性病和健康管理不善使用和治疗依从性差 - 增加认知障碍的风险。我们的 2020 LitCog 更新增加了第五、六次后续采访。我们寻求启动一个平行的中年队列（“MidCog”；年龄 40-64；N=1200），前两次评估相隔 2.5 年进行。我们的具体目标是：1）描述健康素养，中年成年人的自我管理技能和认知功能的详细信息； 2) 评估关联健康素养、自我管理技能、健康行为、医疗保健使用、健康状况、慢性病之间随着时间的推移，结果和认知功能； 3) 调查某些可改变的、社会心理的、中年的调节健康素养、自我管理技能、健康状况和认知之间关联的因素；和 4) 使用 MidCog + LitCog 数据，探索年龄、健康素养、自我管理技能、健康状况之间的关联 40 至 90 岁成年人慢性病的状况、存在和管理以及认知功能。我们将补充现有的中年研究并为卫生系统策略提供信息以保持认知功能。