HIGLIGHTS
- •What is the primary question addressed by this study?This study addressed the distribution and associated factors of functional health literacy measured by the Short Test of Functional Health Literacy (S-TOFHLA) in an older, population-based cohort.
- •What is the main finding of this study?The main finding was that 7% of the older adults had inadequate or marginal health literacy. These individuals were older, male, and had low reading levels.
- •What is the meaning of the finding?Clinicians should be aware of patients’ functional health literacy and tailor their communications accordingly.
ABSTRACT
Objectives
To investigate functional health literacy and its associated factors among older adults
drawn from a disadvantaged area.
Design
Cross-sectional epidemiologic study.
Setting
Population-based cohort randomly selected from the voter registration lists.
Participants
Individuals aged 65+ (N=1066).
Measurements
The Short Test of Functional Health Literacy in Adults (S-TOFHLA); demographics; self-rated
health; number of prescription drugs; modified Center for Epidemiologic Studies- Depression
scale; Mini-Mental State Examination; Wechsler Test of Adult Reading; Clinical Dementia
Rating; cognitive domain composite scores; independence in Instrumental Activities
of Daily Living and medication management; health services utilization (emergency/urgent
care visits and hospitalizations).
Results
Low (inadequate or marginal) S-TOFHLA scores were obtained by 7.04% of the sample.
In unadjusted analyses, participants with low S-TOFHLA scores were significantly more
likely than those with higher scores to be older, male, non-White, with lesser education
and lower household income, to have lower scores on the Wechsler Test of Adult Reading,
the Mini-Mental State Examination, and all cognitive domains; to be more dependent
in Instrumental Activities of Daily Living and be taking more prescription drugs.
In a multiple regression model including all covariates, only older age, male sex,
and lower reading level were independently associated with inadequate or marginal
S-TOFHLA scores.
Conclusion
In a population-based sample of older adults, low functional health literacy was associated
with age, sex, education, and reading ability. Basic functional health literacy is
essential for understanding health information and instructions. Clinicians should
formally or informally assess health literacy in their older patients to ensure effective
communication and enhance health outcomes.
Key Words
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Article info
Publication history
Published online: December 11, 2020
Accepted:
December 8,
2020
Received in revised form:
October 23,
2020
Received:
September 11,
2020
Footnotes
The work reported here was supported in part by grant # R01AG023651 from the National Institute on Aging, NIH, US DHHS.
Identification
Copyright
© 2020 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
