Morrow Dan, Clark Dan, Tu Wanzhu, Wu Jingwei, Weiner Michael, Steinley Douglas, Murray Michael D
Beckman Institute of Advanced Science & Technology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA.
Gerontologist. 2006 Oct;46(5):669-76. doi: 10.1093/geront/46.5.669.
Many older adults have inadequate health-related literacy, which is associated with poor health outcomes. Thus, it is important to identify determinants of health literacy. We investigated relationships between health literacy and general cognitive and sensory abilities, as well as education, health, and demographic variables, in a community sample of middle-aged and older adults.
Participants were 314 community-dwelling adults (67% female, 48% African American) diagnosed with chronic heart failure recruited for a pharmacist-based intervention study to improve adherence to chronic heart failure medications. We adminstered demographic, health, education, cognitive (e.g., processing speed, working memory), and sensory measures, and the Short Test of Functional Health Literacy in Adults (STOFHLA), as part of the baseline condition of this study.
STOFHLA scores were lower for participants who were older, less educated, male, African American, had more comorbidities, or scored lower on all cognitive ability measures. Hierarchical linear regression analyses showed that education and cognitive ability were independently associated with the STOFHLA measure and explained age differences in health literacy.
The association of cognitive abilities and literacy has important implications for health literacy models and for interventions to reduce the impact of low health literacy on health outcomes. For example, medication instructions should be designed to reduce comprehension demands on general cognitive abilities as well as literacy skills.
许多老年人的健康相关素养不足，这与不良健康结果相关。因此，识别健康素养的决定因素很重要。我们在一个中年及老年社区样本中，研究了健康素养与一般认知和感官能力以及教育、健康和人口统计学变量之间的关系。
参与者为314名社区居住成年人（67%为女性，48%为非裔美国人），他们被诊断患有慢性心力衰竭，被招募参加一项基于药剂师的干预研究，以提高对慢性心力衰竭药物的依从性。作为本研究基线条件的一部分，我们进行了人口统计学、健康、教育、认知（如处理速度、工作记忆）和感官测量，以及成人功能性健康素养简短测试（STOFHLA）。
年龄较大、受教育程度较低、男性、非裔美国人、患有更多合并症或在所有认知能力测量中得分较低的参与者，其STOFHLA分数较低。分层线性回归分析表明，教育和认知能力与STOFHLA测量独立相关，并解释了健康素养的年龄差异。
认知能力与素养之间的关联对健康素养模型以及减少低健康素养对健康结果影响的干预措施具有重要意义。例如，药物说明书的设计应减少对一般认知能力以及读写技能的理解要求。
