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

Association between low functional health literacy and mortality in older adults: longitudinal cohort study
Association between low functional health literacy and mortality in older adults: longitudinal cohort study
Objective: To investigate the association between low functional health literacy (ability to read and understand basic health related information) and mortality in older adults.

Design: Population based longitudinal cohort study based on a stratified random sample of households.

Setting: England.

Participants: 7857 adults aged 52 or more who participated in the second wave (2004-5) of the English Longitudinal Study of Ageing and survived more than 12 months after interview. Participants completed a brief four item test of functional health literacy, which assessed understanding of written instructions for taking an aspirin tablet.

Main outcome measure: Time to death, based on all cause mortality through October 2009.

Results: Health literacy was categorised as high (maximum score, 67.2%), medium (one error, 20.3%), or low (more than one error, 12.5%). During follow-up (mean 5.3 years) 621 deaths occurred: 321 (6.1%) in the high health literacy category, 143 (9.0%) in the medium category, and 157 (16.0%) in the low category. After adjusting for personal characteristics, socioeconomic position, baseline health, and health behaviours, the hazard ratio for all cause mortality for participants with low health literacy was 1.40 (95% confidence interval 1.15 to 1.72) and with medium health literacy was 1.15 (0.94 to 1.41) compared with participants with high health literacy. Further adjustment for cognitive ability reduced the hazard ratio for low health literacy to 1.26 (1.02 to 1.55).

Conclusions: A third of older adults in England have difficulties reading and understanding basic health related written information. Poorer understanding is associated with higher mortality. The limited health literacy capabilities within this population have implications for the design and delivery of health related services for older adults in England.
0959-8138
1-10
Bostock, Sophie
5d66bf73-84c2-4c79-bd07-f335f03e8931
Steptoe, Andrew
aadc4799-ddd7-4013-a8c9-c37ec87f23c3
Bostock, Sophie
5d66bf73-84c2-4c79-bd07-f335f03e8931
Steptoe, Andrew
aadc4799-ddd7-4013-a8c9-c37ec87f23c3

Bostock, Sophie and Steptoe, Andrew (2012) Association between low functional health literacy and mortality in older adults: longitudinal cohort study. British Medical Journal, 344 (e1602), 1-10. (doi:10.1136/bmj.e1602). (PMID:22422872)

Record type: Article

Abstract

Objective: To investigate the association between low functional health literacy (ability to read and understand basic health related information) and mortality in older adults.

Design: Population based longitudinal cohort study based on a stratified random sample of households.

Setting: England.

Participants: 7857 adults aged 52 or more who participated in the second wave (2004-5) of the English Longitudinal Study of Ageing and survived more than 12 months after interview. Participants completed a brief four item test of functional health literacy, which assessed understanding of written instructions for taking an aspirin tablet.

Main outcome measure: Time to death, based on all cause mortality through October 2009.

Results: Health literacy was categorised as high (maximum score, 67.2%), medium (one error, 20.3%), or low (more than one error, 12.5%). During follow-up (mean 5.3 years) 621 deaths occurred: 321 (6.1%) in the high health literacy category, 143 (9.0%) in the medium category, and 157 (16.0%) in the low category. After adjusting for personal characteristics, socioeconomic position, baseline health, and health behaviours, the hazard ratio for all cause mortality for participants with low health literacy was 1.40 (95% confidence interval 1.15 to 1.72) and with medium health literacy was 1.15 (0.94 to 1.41) compared with participants with high health literacy. Further adjustment for cognitive ability reduced the hazard ratio for low health literacy to 1.26 (1.02 to 1.55).

Conclusions: A third of older adults in England have difficulties reading and understanding basic health related written information. Poorer understanding is associated with higher mortality. The limited health literacy capabilities within this population have implications for the design and delivery of health related services for older adults in England.

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More information

Accepted/In Press date: 1 February 2012
Published date: 16 March 2012
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 396015
URI: https://eprints.soton.ac.uk/id/eprint/396015
ISSN: 0959-8138
PURE UUID: f94a12a8-74f9-4062-8435-f345e136d531

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Date deposited: 14 Jul 2016 15:45
Last modified: 11 Nov 2019 20:16

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