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Cognitive Function and Health Literacy Decline in a Cohort of Aging English Adults.

Kobayashi LC, Wardle J, Wolf MS, von Wagner C - J Gen Intern Med (2015)

Bottom Line: Among adults aged ≥ 80 years at baseline, this proportion was 38.2% (102/267), compared to 14.8% (78/526) among adults aged 52-54 years (OR = 3.21; 95% CI: 2.26-4.57).Health literacy decline appeared to increase with age, and was associated with even subtle cognitive decline in older non-impaired adults.Health practitioners must be able to recognize limited health literacy to ensure that clinical demands match the literacy skills of diverse patients.

View Article: PubMed Central - PubMed

Affiliation: Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, 2nd floor, London, UK, WC1E 6BT, l.kobayashi.12@ucl.ac.uk.

ABSTRACT

Background: Low health literacy is common among aging patients and is a risk factor for morbidity and mortality. We aimed to describe health literacy decline during aging and to investigate the roles of cognitive function and decline in determining health literacy decline.

Methods: Data were from 5,256 non-cognitively impaired adults aged ≥ 52 years in the English Longitudinal Study of Ageing. Health literacy was assessed using a four-item reading comprehension assessment of a fictitious medicine label, and cognitive function was assessed in a battery administered in-person at baseline (2004-2005) and at follow-up (2010-2011).

Results: Overall, 19.6% (1,032/5,256) of participants declined in health literacy score over the follow-up. Among adults aged ≥ 80 years at baseline, this proportion was 38.2% (102/267), compared to 14.8% (78/526) among adults aged 52-54 years (OR = 3.21; 95% CI: 2.26-4.57). Other sociodemographic predictors of health literacy decline were: male sex (OR = 1.20; 95% CI: 1.04-1.38), non-white ethnicity (OR = 2.42; 95% CI: 1.51-3.89), low educational attainment (OR = 1.58; 95% CI: 1.29-1.95 for no qualifications vs. degree education), and low occupational class (OR = 1.67; 95% CI: 1.39-2.01 for routine vs. managerial occupations). Higher baseline cognitive function scores protected against health literacy decline, while cognitive decline (yes vs. no) predicted decline in health literacy score (OR = 1.59; 95% CI: 1.35-1.87 for memory decline and OR = 1.56; 95% CI: 1.32-1.85 for executive function decline).

Conclusions: Health literacy decline appeared to increase with age, and was associated with even subtle cognitive decline in older non-impaired adults. Striking social inequalities were evident, whereby men and those from minority and deprived backgrounds were particularly vulnerable to literacy decline. Health practitioners must be able to recognize limited health literacy to ensure that clinical demands match the literacy skills of diverse patients.

No MeSH data available.


Related in: MedlinePlus

Mean health literacy scores between ELSA waves 2 (2004–2005) and 5 (2010–2011) by 5-year age group.
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Related In: Results  -  Collection


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Fig1: Mean health literacy scores between ELSA waves 2 (2004–2005) and 5 (2010–2011) by 5-year age group.

Mentions: At baseline, 1,455/5,256 (27.7 %) participants had limited health literacy (Table 1). When followed forward to wave 5, 3,260/5,256 participants (62.0 %) had no change in their health literacy score, while 964/5,256 (18.3 %) improved by ≥ 1 point and 1,032/5,256 (19.6 %) declined by ≥ 1 point. Chi-squared tests showed that improvement in score was non-differential by age (p = 0.53), while decline was more frequent in older age groups (p < 0.001). The proportion that declined increased linearly with age from 14.8 % (78/526) of those aged 52–54 years (102/267) to 38.2 % of those aged ≥ 80 years (p < 0.0001). As shown in Fig. 1, mean health literacy scores declined over the study follow-up for age groups from 65–69 years and older; this decline was statistically significant for the 75–79 (p = 0.008) and ≥ 80 (p < 0.001) groups.Table 1.


Cognitive Function and Health Literacy Decline in a Cohort of Aging English Adults.

Kobayashi LC, Wardle J, Wolf MS, von Wagner C - J Gen Intern Med (2015)

Mean health literacy scores between ELSA waves 2 (2004–2005) and 5 (2010–2011) by 5-year age group.
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4471026&req=5

Fig1: Mean health literacy scores between ELSA waves 2 (2004–2005) and 5 (2010–2011) by 5-year age group.
Mentions: At baseline, 1,455/5,256 (27.7 %) participants had limited health literacy (Table 1). When followed forward to wave 5, 3,260/5,256 participants (62.0 %) had no change in their health literacy score, while 964/5,256 (18.3 %) improved by ≥ 1 point and 1,032/5,256 (19.6 %) declined by ≥ 1 point. Chi-squared tests showed that improvement in score was non-differential by age (p = 0.53), while decline was more frequent in older age groups (p < 0.001). The proportion that declined increased linearly with age from 14.8 % (78/526) of those aged 52–54 years (102/267) to 38.2 % of those aged ≥ 80 years (p < 0.0001). As shown in Fig. 1, mean health literacy scores declined over the study follow-up for age groups from 65–69 years and older; this decline was statistically significant for the 75–79 (p = 0.008) and ≥ 80 (p < 0.001) groups.Table 1.

Bottom Line: Among adults aged ≥ 80 years at baseline, this proportion was 38.2% (102/267), compared to 14.8% (78/526) among adults aged 52-54 years (OR = 3.21; 95% CI: 2.26-4.57).Health literacy decline appeared to increase with age, and was associated with even subtle cognitive decline in older non-impaired adults.Health practitioners must be able to recognize limited health literacy to ensure that clinical demands match the literacy skills of diverse patients.

View Article: PubMed Central - PubMed

Affiliation: Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, 2nd floor, London, UK, WC1E 6BT, l.kobayashi.12@ucl.ac.uk.

ABSTRACT

Background: Low health literacy is common among aging patients and is a risk factor for morbidity and mortality. We aimed to describe health literacy decline during aging and to investigate the roles of cognitive function and decline in determining health literacy decline.

Methods: Data were from 5,256 non-cognitively impaired adults aged ≥ 52 years in the English Longitudinal Study of Ageing. Health literacy was assessed using a four-item reading comprehension assessment of a fictitious medicine label, and cognitive function was assessed in a battery administered in-person at baseline (2004-2005) and at follow-up (2010-2011).

Results: Overall, 19.6% (1,032/5,256) of participants declined in health literacy score over the follow-up. Among adults aged ≥ 80 years at baseline, this proportion was 38.2% (102/267), compared to 14.8% (78/526) among adults aged 52-54 years (OR = 3.21; 95% CI: 2.26-4.57). Other sociodemographic predictors of health literacy decline were: male sex (OR = 1.20; 95% CI: 1.04-1.38), non-white ethnicity (OR = 2.42; 95% CI: 1.51-3.89), low educational attainment (OR = 1.58; 95% CI: 1.29-1.95 for no qualifications vs. degree education), and low occupational class (OR = 1.67; 95% CI: 1.39-2.01 for routine vs. managerial occupations). Higher baseline cognitive function scores protected against health literacy decline, while cognitive decline (yes vs. no) predicted decline in health literacy score (OR = 1.59; 95% CI: 1.35-1.87 for memory decline and OR = 1.56; 95% CI: 1.32-1.85 for executive function decline).

Conclusions: Health literacy decline appeared to increase with age, and was associated with even subtle cognitive decline in older non-impaired adults. Striking social inequalities were evident, whereby men and those from minority and deprived backgrounds were particularly vulnerable to literacy decline. Health practitioners must be able to recognize limited health literacy to ensure that clinical demands match the literacy skills of diverse patients.

No MeSH data available.


Related in: MedlinePlus