Association between low functional health literacy and mortality in older adults: longitudinal cohort study

Abstract The aim of the current study is to provide comprehensive health care to older adults by assessing physical and mental health in a geriatric primary care setting, including evaluation of both subjective and functional health literacy. Health literacy is vital to understanding medical information and making subsequent decisions based on this information. Knowledge of patient health literacy may be particularly important for care providers, as it can provide guidance on how to best communicate with the patient (Nouri & Rudd, 2015). It may be particularly important to monitor health literacy within older adults, as several studies (e.g., Kobayashi et al., 2015) have shown that health literacy decreases with mild cognitive impairment. Approximately 250 patients (mean age = 76; 74% female; 16% African American) attending an interdisciplinary geriatrics clinic in West Alabama have been recruited to take part in a variety of behavioral health screenings. The current study assessed subjective health literacy using questions developed by Chew, Bradley, and Boyko (2004) and functional health literacy using the Newest Vital Sign (Weiss et al., 2005). While there was a significant correlation between subjective and functional health literacy (r = .43, p < .001), 81% of patients reported adequate subjective health literacy, while only 41% demonstrated adequate health literacy on a functional screening measure. Based on these findings, self-reported health literacy may not necessarily be reflective of performance on more functional measures. Given the potential consequences of overestimating health literacy, this represents a serious barrier to patient care.

Download Full-text

Disabilities in activities of daily living and in instrumental activities of daily living among older adults in China, 2011–15: a longitudinal cohort study

The Lancet ◽

10.1016/s0140-6736(19)32418-3 ◽

2019 ◽

Vol 394 ◽

pp. S82 ◽

Cited By ~ 1

Author(s):

Mingming Yan ◽

Tingting Qin ◽

Ping Yin

Keyword(s):

Older Adults ◽

Cohort Study ◽

Activities Of Daily Living ◽

Daily Living ◽

Longitudinal Cohort Study ◽

Longitudinal Cohort ◽

Instrumental Activities

Download Full-text

Internet Use and Cancer-Preventive Behaviors in Older Adults: Findings from a Longitudinal Cohort Study

Cancer Epidemiology Biomarkers & Prevention ◽

10.1158/1055-9965.epi-13-0542 ◽

2013 ◽

Vol 22 (11) ◽

pp. 2066-2074 ◽

Cited By ~ 36

Author(s):

Andre Junqueira Xavier ◽

Eleonora d'Orsi ◽

Jane Wardle ◽

Panayotes Demakakos ◽

Samuel G. Smith ◽

...

Keyword(s):

Older Adults ◽

Cohort Study ◽

Internet Use ◽

Longitudinal Cohort Study ◽

Preventive Behaviors ◽

Longitudinal Cohort

Download Full-text

Predictors of Health Deterioration Among Older Adults After 12 Months of Dialysis Therapy: A Longitudinal Cohort Study From New Zealand

American Journal of Kidney Diseases ◽

10.1053/j.ajkd.2017.06.023 ◽

2017 ◽

Vol 70 (6) ◽

pp. 798-806 ◽

Cited By ~ 10

Author(s):

Sarah Derrett ◽

Ari Samaranayaka ◽

John B.W. Schollum ◽

Bronwen McNoe ◽

Mark R. Marshall ◽

...

Keyword(s):

Older Adults ◽

Cohort Study ◽

New Zealand ◽

Longitudinal Cohort Study ◽

Dialysis Therapy ◽

Longitudinal Cohort ◽

Health Deterioration

Download Full-text

The relationship between functional health literacy and health promoting behaviors among older adults

Journal of Education and Health Promotion ◽

10.4103/2277-9531.145925 ◽

2014 ◽

Vol 3 (1) ◽

pp. 119 ◽

Cited By ~ 20

Author(s):

Gholamreza Sharifirad ◽

Mahnoush Reisi ◽

SeyedHomamodin Javadzade ◽

AkbarBabaei Heydarabadi ◽

Firouzeh Mostafavi ◽

...

Keyword(s):

Older Adults ◽

Health Literacy ◽

Functional Health ◽

Functional Health Literacy ◽

Health Promoting Behaviors ◽

Health Promoting ◽

The Relationship

Download Full-text

Mastery and self-esteem mediate the association between visual acuity and mental health: a population-based longitudinal cohort study

10.21203/rs.3.rs-17498/v1 ◽

2020 ◽

Author(s):

Hilde PA van der Aa ◽

Ivar M Maaswinkel ◽

Ger HMB van Rens ◽

Aartjan TF Beekman ◽

Jos WR Twisk ◽

...

Keyword(s):

Mental Health ◽

Older Adults ◽

Visual Acuity ◽

Cohort Study ◽

Visual Impairment ◽

Self Esteem ◽

Longitudinal Cohort Study ◽

Longitudinal Cohort ◽

The Relationship ◽

Sense Of Mastery

Abstract Background With deteriorating eyesight, people often become dependent on others for many aspects of their daily lives. As a result, they feel less ‘in control’ and experience lower self-esteem. Lower sense of mastery and self-esteem are known to predict depression, but their roles in people with visual impairment remain unknown. Therefore, this study aimed to determine the influence of mastery and self-esteem on the relationship between visual acuity and mental health. Methods A longitudinal cohort study was performed using data from the Longitudinal Aging Study Amsterdam (LASA). Data on vision was available from the fifth cycle (2001), with a mean follow-up of 5.9 years. A community-based population was studied, containing older adults from eleven municipalities in three culturally distinct geographical regions in the Netherlands. A total of 2599 older adults (aged 55 to 85 years at baseline) were included, who were randomly selected from population registers in 1992. The first (2001) and last (2012) included measurements contained 1961 and 1522 participants, respectively. Primary study outcomes were logMAR visual acuity, sense of mastery, self-esteem, depression and anxiety. Instead of standard questionnaire scores, latent trait scores (θ) were obtained through -) Item Response Theory (IRT-) analysis. Results Mean age was 72 years, with 56% females and 2% qualifying as low vision. Visual impairment was associated with a lower sense of mastery (β = -0.477, p < 0.001), lower self-esteem (β = -0.166, p = 0.008) and more depression (β = 0.235, p < 0.001). No significant association between visual acuity and anxiety was found. The relationship between visual acuity and depression was mediated partially by self-esteem (25%) and fully by sense of mastery (76%). Conclusions Vision loss was associated with depression. This association was mediated by self-esteem and sense of mastery. This provides us with new possibilities to identify, support and treat those at risk for developing depression by aiming to increase their self-esteem and sense of mastery.

Download Full-text

Role of cognitive ability in the association between functional health literacy and mortality in the Lothian Birth Cohort 1936: a prospective cohort study

BMJ Open ◽

10.1136/bmjopen-2018-022502 ◽

2018 ◽

Vol 8 (9) ◽

pp. e022502 ◽

Cited By ~ 5

Author(s):

Chloe Fawns-Ritchie ◽

John M Starr ◽

Ian J Deary

Keyword(s):

Cohort Study ◽

Health Literacy ◽

Cognitive Ability ◽

Birth Cohort ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Functional Health ◽

Functional Health Literacy ◽

Fluid Type ◽

Lothian Birth Cohort

ObjectivesWe investigated the role that childhood and old age cognitive ability play in the association between functional health literacy and mortality.DesignProspective cohort study.SettingThis study used data from the Lothian Birth Cohort 1936 (LBC1936) study, which recruited participants living in the Lothian region of Scotland when aged 70 years, most of whom had completed an intelligence test at age 11 years.Participants795 members of the LBC1936 with scores on tests of functional health literacy and cognitive ability in childhood and older adulthood.Primary and secondary outcome measuresParticipants were followed up for 8 years to determine mortality. Time to death in days was used as the primary outcome measure.ResultsUsing Cox regression, higher functional health literacy was associated with lower risk of mortality adjusting for age and sex, using the Shortened Test of Functional Health Literacy in Adults (HR 0.95, 95% CI 0.92 to 0.98), the Newest Vital Sign (HR 0.88, 95% CI 0.80 to 0.97) and a functional health literacy composite measure (HR 0.77, 95% CI 0.65 to 0.92), but not the Rapid Estimate of Adult Literacy in Medicine (HR 0.95, 95% CI 0.90 to 1.01). Adjusting for childhood intelligence did not change these associations. When additionally adjusting for fluid-type cognitive ability in older age, associations between functional health literacy and mortality were attenuated and non-significant.ConclusionsCurrent fluid ability, but not childhood intelligence, attenuated the association between functional health literacy and mortality. Functional health literacy measures may, in part, assess fluid-type cognitive abilities, and this may account for the association between functional health literacy and mortality.

Download Full-text

The Relationship between Functional Health Literacy, Self-Rated Health, and Social Support between Younger and Older Adults in Ghana

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16173188 ◽

2019 ◽

Vol 16 (17) ◽

pp. 3188 ◽

Cited By ~ 4

Author(s):

Padmore Amoah

Keyword(s):

Social Support ◽

Older Adults ◽

Young Adults ◽

Health Status ◽

Health Literacy ◽

Emotional Support ◽

Functional Health ◽

Functional Health Literacy ◽

Self Rated Health ◽

The Impact

It is well established that health literacy positively affects health outcomes, and social support influences this association. What remains unclear is which aspect of social support (instrumental, informational, and emotional support) is responsible for this effect and whether the influence differs from one population group to another. This study addresses these lacunae. It examines the impact each type of support makes on the relation between functional health literacy (FHL) and self-rated health status among younger and older adults in Ghana. Data were pooled from two cross-sectional surveys, together comprising 521 participants in the Ashanti Region. The results indicated that young adults were more likely to possess sufficient FHL and perceive their health more positively than older adults. While FHL was positively associated with health status, the relation was stronger when young adults received a high level of emotional support. Among older persons, informational support substantially moderated the association between FHL and health status. Thus, social support modifies the relations between FHL and health status among younger and older adults in different ways and to different degrees. Therefore, interventions to improve FHL and health amongst younger and older adults should pay due regard to relevant aspects of social support.

Download Full-text