Ayda Rostamzadeh, MD, Department of Psychiatry and Psychotherapy, University of Cologne, Kerpener Straße 62, 50937 Cologne, Germany, Phone: +49 (0)221 - 478 3870, Fax: +49 (0)221 - 478 6030, E-Mail:
J Prev Alzheimers Dis. 2020;7(1):47-55. doi: 10.14283/jpad.2019.34.
Health literacy (HL) refers to the capacity to access, understand, appraise and apply information for decision-making and acting in health-related matters. In the field of Alzheimer's disease (AD), expanding technologies of early disease detection, disease course prediction and eventually personalized prevention confront individuals at-risk with increasingly complex information, which demand substantial HL skills. Here we report current findings of HL research in at-risk groups.
Search strings, referring to HL, AD, amyloid and risk, were developed. A systematic review was conducted in PUBMED, Cochrane Library, PsycINFO, and Web of Science to summarize the state of evidence on HL in at-risk individuals for Alzheimer's dementia. Eligible articles needed to employ a validated tool for HL, mention the concept or one dimension (access, understand, appraise and apply information for decision-making and acting).
26 quantitative and 9 qualitative studies addressing at least one dimension of HL were included. Overall, there is evidence for a wish to gain knowledge about the own brain status and risk of dementia. Psychological distress may occur and the subjective benefit-risk estimation may be modified after risk disclosure. Effects on lifestyle and planning may occur. Overall understanding and appraisal of information related to AD risk seem variable with several impacting factors. In mild cognitive impairment (MCI) basic HL skill seem to be affected by cognitive dysfunction.
Systematic assessment of HL in at-risk population for AD is sparse. Findings indicate the paramount importance of adequate communication with persons at risk, being sensitive to individual needs and preferences. Substantial research needs were identified.
健康素养（HL）是指获取、理解、评估和应用健康相关信息以做出决策和采取行动的能力。在阿尔茨海默病（AD）领域，扩展的早期疾病检测、疾病进程预测和最终的个性化预防技术使处于风险中的个体面临越来越复杂的信息，这需要大量的 HL 技能。本文报告了 AD 高危人群 HL 研究的现状。
制定了涉及 HL、AD、淀粉样蛋白和风险的检索词。在 PUBMED、Cochrane Library、PsycINFO 和 Web of Science 中进行了系统评价，以总结 AD 高危人群 HL 方面的证据现状。合格的文章需要使用经过验证的 HL 工具，提及概念或一个维度（获取、理解、评估和应用信息以做出决策和采取行动）。
共纳入 26 项定量研究和 9 项定性研究，至少涉及 HL 的一个维度。总体而言，人们希望了解自己的大脑状况和痴呆风险。风险披露后可能会出现心理困扰，主观的获益-风险评估可能会改变。对生活方式和计划的影响可能会发生。AD 风险相关信息的总体理解和评估似乎存在差异，有几个影响因素。在轻度认知障碍（MCI）中，基本 HL 技能似乎受到认知功能障碍的影响。
AD 高危人群 HL 的系统评估很少。研究结果表明，与高危人群进行充分沟通，对个体需求和偏好保持敏感至关重要。还确定了大量的研究需求。
