Mary Ganguli1, Tiffany F Hughes2, Yichen Jia3, Jennifer Lingler4, Erin Jacobsen5, Chung-Chou H Chang6. 1. Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA; Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA; Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. Electronic address: GanguliM@upmc.edu. 2. Department of Health Professions, Bitonte College of Health and Human Services, Youngstown State University, Youngstown, OH. 3. Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA. 4. Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA; Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA; Clinical and Translational Science Institute, School of Medicine, University of Pittsburgh, Pittsburgh, PA. 5. Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA. 6. Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA; Department of Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA.
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.
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.
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