LITCOG II: Health Literacy and Cognitive Function among Older Adults

描述(由申请人提供)：我们建议扩展我们目前的健康素养调查[‘LitCog’；R01AG030611]，并在社区居住的老年人中评估随着时间的推移识字技能、认知功能和健康结果之间的关联。越来越多的调查人员质疑，认知功能是否可以解释为什么健康素养较低的成年人健康状况较差。我们团队目前正在进行一项由NIA资助的横断面研究，名为“老年人的健康素养和认知功能”(又名。‘LitCog’)。其目的是调查健康素养和认知功能之间的关系，并确定这些因素如何预测常见健康任务的表现。我们现在建议对LitCog参与者(N=1100)进行跟踪调查，并在5年期间检查识字、认知功能、在常见健康任务中的表现和健康状况之间的关系。一项纵向研究将深入调查老年人的健康素养技能，以及他们的健康管理能力如何受到认知衰退和老龄化过程的影响。拟议的队列研究将提高我们对以下问题的理解：1)低健康素养问题背后的真正障碍，以及2)如何最好地为当前和未来的干预战略提供信息。我们的主要研究目的是：1)确定老年人的健康素养技能是否随着时间的推移而发生变化，以及这些变化是否与认知功能的下降有关；2)评估老年人的健康素养、认知功能和健康状况之间的关系；3)调查可能中介或调节老年人识字技能、认知功能和健康状况之间关系的心理社会因素；我们的次要目标是：4)探索提高老年人在主要依赖流动认知能力的健康任务中的表现的策略。我们将对以前参与LitCog研究的老年人进行后续访谈(T2-2.5年；基线访谈后T3-5年)；实施基线单元中给出的相同的健康素养、认知功能和健康状况测量。在目标4中，我们将嵌入一系列受控的横断面实验，以测试提高老年人在复杂健康任务中表现的具体策略。 公共卫生相关性：识字率有限与健康结果差之间的程度和联系已被反复记录在案，但具体的因果路径并不完全清楚。这项拟议的纵向研究将深入调查老年人的健康素养和管理健康的能力，以及这些技能是否受到认知衰退和老龄化过程的影响。我们的研究将提高我们对低健康素养问题背后的真正障碍的理解，以及如何最好地为当前和未来的干预战略提供信息。

DESCRIPTION (provided by applicant): We propose to extend our current health literacy investigation ['LitCog'; R01AG030611] and evaluate the association between literacy skills, cognitive function, and health outcomes over time among an established cohort of community-dwelling, older adults. An increasing number of investigators are questioning whether cognitive function might explain why adults with low 'health literacy' experience poorer health. Our team is currently conducting an NIA-funded, cross-sectional study, "Health Literacy and Cognitive Function among Older Adults" (a.k.a. 'LitCog'). The objective is to investigate the relationship between health literacy and cognitive function, and to determine how these factors predict performance on common health tasks. We now propose to follow-up LitCog participants (N=1100) and examine the association between literacy, cognitive function, performance on common health tasks, and health status over a 5-year period. A longitudinal study will provide an in-depth investigation of older adults' health literacy skills, and how their ability to manage health is affected by cognitive decline and the aging process. The proposed cohort study will improve our understanding of: 1) the true barriers underlying the problem of low health literacy, and 2) how best to inform present and future intervention strategies. Our primary study aims are to: 1) Determine whether older adults' health literacy skills change over time, and if these changes are associated with a decline in cognitive function; 2) Evaluate the association between health literacy, cognitive function, and health status among older adults; 3) Investigate psychosocial factors that potentially mediate or moderate the association between literacy skills, cognitive function, and health status among older adults; and our secondary aim is to: 4) Explore strategies to enhance older adults' performance on health tasks that mostly rely on fluid cognitive abilities. We will conduct follow-up interviews (T2 - 2.5 years; T3 - 5 years post-baseline interview) with older adults who previously participated in the LitCog study; administering the same health literacy, cognitive function, and health status measures given in the baseline battery. In Aim 4, we will embed a series of controlled, cross-sectional experiments to test specific strategies to increase older adults' performance on complex health tasks. PUBLIC HEALTH RELEVANCE: The extent and association between limited literacy and poor health outcomes has been repeatedly documented, yet specific causal pathways are not entirely clear. The proposed longitudinal study will provide an in-depth investigation of older adults' health literacy and ability to manage health, and whether these skills are affected by cognitive decline and the aging process. Our research will improve our understanding of the true barriers underlying the problem of low health literacy, and how best to inform present and future intervention strategies.