# Impact of change in lifestyle health behaviors on cognition: Harmonizing and leveraging participant-level data from randomized controlled trials

> **NIH NIH RF1** · UNIVERSITY OF ILLINOIS AT CHICAGO · 2024 · $2,366,213

## Abstract

Lifestyle health behaviors, such as physical activity, cognitive activity, healthy diet, and social activity, are low-
risk, non-pharmaceutical strategies that may help protect against cognitive decline and risk of Alzheimer's
disease and related dementias (AD/ADRD). However, causal evidence across observational and trial research
is inconsistent. There remains a need to further understand the impact of lifestyle health behaviors on cognitive
outcomes, including what type(s) of behavior and magnitude of behavior change have greatest impact, and if
impact differs across diverse at-risk subgroups. The purpose of our proposed study, InLife (Individualized
Lifestyle Change For Every Aging Brain), is to harmonize existing participant-level data from randomized
controlled trials (RCTs) to examine how changes in lifestyle health behavior impact cognitive outcomes across
diverse adults. We will leverage previously collected de-identified data from 12 U.S. trials representing 9,570
older adults for de novo analyses. In trials that agreed to contribute data, one or more lifestyle health behaviors
(physical activity, cognitive activity, healthy diet, and/or social activity) were targeted and cognitive outcomes
were assessed, including change in cognitive function (primary outcome: episodic memory and executive
function, secondary outcome: perceptual speed and global cognition) and (in some) incidence of mild cognitive
impairment or dementia (exploratory outcome). Aim 1: Quantify impact of changes in lifestyle health behaviors
on cognitive outcomes. Following our innovative harmonization methods based on an item response theory
framework, we will harmonize data across trials to test hypotheses that (a) the association between amount of
change in behaviors and cognitive outcomes will be strongest for those with lower initial levels of the targeted
behavior and (b) there will be nonlinear effects of increases in behaviors on cognitive outcomes such that
benefits will diminish as behavior change increases (i.e., diminishing returns). Aim 2: Examine determinants of
health that moderate (enhance or inhibit) impact of lifestyle health behavior change on cognitive outcomes. We
will evaluate whether associations between lifestyle health behavior and cognitive outcomes in Aim 1 differ
between subgroups. Informed by National Institute on Aging and World Health Organization frameworks, we
focus on subgroups based on determinants of health that are structural/social (age, sex, education, racial
background, ethnic background), biological (e.g., cardiometabolic disease), and environmental (e.g., rural vs.
urban, U.S. region, area deprivation index [API]). Aim 3 (exploratory): Determine the impact of lifestyle health
behavior combinations on cognitive outcomes. We will evaluate whether two or more behaviors together have
more impact than one alone and quantify which combinations of behaviors are most impactful. The proposed
InLife study will result in the first harmonized ...

## Key facts

- **NIH application ID:** 10984344
- **Project number:** 1RF1AG089550-01
- **Recipient organization:** UNIVERSITY OF ILLINOIS AT CHICAGO
- **Principal Investigator:** Shannon Halloway
- **Activity code:** RF1 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $2,366,213
- **Award type:** 1
- **Project period:** 2024-09-15 → 2027-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10984344

## Citation

> US National Institutes of Health, RePORTER application 10984344, Impact of change in lifestyle health behaviors on cognition: Harmonizing and leveraging participant-level data from randomized controlled trials (1RF1AG089550-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10984344. Licensed CC0.

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