功能健康素养和认知能力与英国老龄化纵向研究中自我报告的糖尿病之间的关联：一项前瞻性队列研究。

Association of functional health literacy and cognitive ability with self-reported diabetes in the English Longitudinal Study of Ageing: a prospective cohort study.

机构信息

Department of Psychology, The University of Edinburgh, Edinburgh, UK

Usher Institute, The University of Edinburgh, Edinburgh, UK.

出版信息

BMJ Open. 2022 Jun 3;12(6):e058496. doi: 10.1136/bmjopen-2021-058496.

DOI:10.1136/bmjopen-2021-058496

PMID:36691240

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9171267/

Abstract

OBJECTIVES

We investigated whether functional health literacy and cognitive ability were associated with self-reported diabetes.

DESIGN

Prospective cohort study.

SETTING

Data were from waves 2 (2004-2005) to 7 (2014-2015) of the English Longitudinal Study of Ageing (ELSA), a cohort study designed to be representative of adults aged 50 years and older living in England.

PARTICIPANTS

8669 ELSA participants (mean age=66.7, SD=9.7) who completed a brief functional health literacy test assessing health-related reading comprehension, and 4 cognitive tests assessing declarative memory, processing speed and executive function at wave 2.

PRIMARY OUTCOME MEASURE

Self-reported doctor diagnosis of diabetes.

RESULTS

Logistic regression was used to examine cross-sectional (wave 2) associations of functional health literacy and cognitive ability with diabetes status. Adequate (compared with limited) functional health literacy (OR 0.71, 95% CI 0.61 to 0.84) and higher cognitive ability (OR per 1 SD=0.73, 95% CI 0.67 to 0.80) were associated with lower odds of self-reporting diabetes at wave 2. Cox regression was used to test the associations of functional health literacy and cognitive ability measured at wave 2 with self-reporting diabetes over a median of 9.5 years follow-up (n=6961). Adequate functional health literacy (HR 0.64; 95% CI 0.53 to 0.77) and higher cognitive ability (HR 0.77, 95% CI 0.69 to 0.85) at wave 2 were associated with lower risk of self-reporting diabetes during follow-up. When both functional health literacy and cognitive ability were added to the same model, these associations were slightly attenuated. Additionally adjusting for health behaviours and body mass index fully attenuated cross-sectional associations between functional health literacy and cognitive ability with diabetes status, and partly attenuated associations between functional health literacy and cognitive ability with self-reporting diabetes during follow-up.

CONCLUSIONS

Adequate functional health literacy and better cognitive ability were independently associated with lower likelihood of reporting diabetes.

摘要

目的

我们研究了功能性健康素养和认知能力是否与自我报告的糖尿病有关。

设计

前瞻性队列研究。

地点

数据来自英国老龄化纵向研究（ELSA）的第 2 波（2004-2005 年）至第 7 波（2014-2015 年），这是一项旨在代表英格兰 50 岁及以上成年人的队列研究。

参与者

8669 名 ELSA 参与者（平均年龄=66.7，标准差=9.7），他们在第 2 波完成了一项简短的功能性健康素养测试，评估与健康相关的阅读理解能力，以及 4 项认知测试，评估陈述性记忆、处理速度和执行功能。

主要结局测量

自我报告的医生诊断的糖尿病。

结果

使用逻辑回归分析了功能性健康素养和认知能力与糖尿病状态的横断面（第 2 波）关联。适当的（与有限的相比）功能性健康素养（OR 0.71，95%CI 0.61-0.84）和更高的认知能力（OR 每 1 SD=0.73，95%CI 0.67-0.80）与第 2 波自我报告的糖尿病几率较低相关。使用 Cox 回归测试了第 2 波测量的功能性健康素养和认知能力与中位 9.5 年随访期间自我报告的糖尿病之间的关联。适当的功能性健康素养（HR 0.64；95%CI 0.53-0.77）和更高的认知能力（HR 0.77，95%CI 0.69-0.85）在随访期间与自我报告的糖尿病风险较低相关。当将功能性健康素养和认知能力同时纳入同一个模型时，这些关联略有减弱。此外，调整健康行为和体重指数后，功能性健康素养和认知能力与糖尿病状态的横断面关联以及功能性健康素养和认知能力与随访期间自我报告的糖尿病之间的关联均部分减弱。