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

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,...

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Autores principales: Kobayashi, Lindsay C., Wardle, Jane, Wolf, Michael S., von Wagner, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4471026/
https://www.ncbi.nlm.nih.gov/pubmed/25680352
http://dx.doi.org/10.1007/s11606-015-3206-9
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author Kobayashi, Lindsay C.
Wardle, Jane
Wolf, Michael S.
von Wagner, Christian
author_facet Kobayashi, Lindsay C.
Wardle, Jane
Wolf, Michael S.
von Wagner, Christian
author_sort Kobayashi, Lindsay C.
collection PubMed
description 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s11606-015-3206-9) contains supplementary material, which is available to authorized users.
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spelling pubmed-44710262015-07-01 Cognitive Function and Health Literacy Decline in a Cohort of Aging English Adults Kobayashi, Lindsay C. Wardle, Jane Wolf, Michael S. von Wagner, Christian J Gen Intern Med Original Research 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s11606-015-3206-9) contains supplementary material, which is available to authorized users. Springer US 2015-02-14 2015-07 /pmc/articles/PMC4471026/ /pubmed/25680352 http://dx.doi.org/10.1007/s11606-015-3206-9 Text en © The Author(s) 2015 https://creativecommons.org/licenses/by/4.0/ Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
spellingShingle Original Research
Kobayashi, Lindsay C.
Wardle, Jane
Wolf, Michael S.
von Wagner, Christian
Cognitive Function and Health Literacy Decline in a Cohort of Aging English Adults
title Cognitive Function and Health Literacy Decline in a Cohort of Aging English Adults
title_full Cognitive Function and Health Literacy Decline in a Cohort of Aging English Adults
title_fullStr Cognitive Function and Health Literacy Decline in a Cohort of Aging English Adults
title_full_unstemmed Cognitive Function and Health Literacy Decline in a Cohort of Aging English Adults
title_short Cognitive Function and Health Literacy Decline in a Cohort of Aging English Adults
title_sort cognitive function and health literacy decline in a cohort of aging english adults
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4471026/
https://www.ncbi.nlm.nih.gov/pubmed/25680352
http://dx.doi.org/10.1007/s11606-015-3206-9
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