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

> **NIH NIH R01** · NORTHWESTERN UNIVERSITY · 2024 · $739,226

## Abstract

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...

## Key facts

- **NIH application ID:** 10846642
- **Project number:** 5R01AG070212-04
- **Recipient organization:** NORTHWESTERN UNIVERSITY
- **Principal Investigator:** MICHAEL S WOLF
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $739,226
- **Award type:** 5
- **Project period:** 2021-08-15 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10846642

## Citation

> US National Institutes of Health, RePORTER application 10846642, Health Literacy and Cognitive Function among Middle-Aged Adults: The MidCog Study (5R01AG070212-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10846642. Licensed CC0.

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