Graduate School of Rehabilitation Science, Osaka Metropolitan University, 3-7-30 Habikino, Habikino-City, Osaka, 583-8555, Japan.
Section of Education for Clinical Research, Kyoto University Hospital, Kyoto, Japan.
Aging Clin Exp Res. 2023 Jun;35(6):1253-1261. doi: 10.1007/s40520-023-02405-y. Epub 2023 Apr 23.
We aimed to investigate whether high community-level health literacy, beyond individual-level health literacy, is associated with a low prevalence of frailty among community-dwelling older adults.
A large cross-sectional questionnaire survey was conducted among citizens in Maizuru City, Kyoto, Japan, aged 65 years or older who were not certified as "support" or "care" level according to Japan's public long-term care insurance system, who could perform basic activities of daily living, and who did not have dementia or Parkinson's disease. Frailty status was assessed using the Kihon Checklist, with a score ≥ 8 indicating frailty. Health literacy was assessed using the Communicative and Critical Health Literacy Scale. The mean health literacy score of 20 school districts was used as the community-level health literacy index. We investigated demographic data and other potential confounding factors, including education, living arrangement, body mass index, comorbidity, smoking status, depressive symptoms, social networks, and community-level covariates.
The primary analysis included 6230 individuals (mean age = 74.3 years [SD = 6.1]). In each school district, the prevalence of frailty was 21.2-34.2% (mean: 26.2%), and community-level health literacy index was 3.1-3.5 (mean: 3.4). Multilevel logistic regression model including school district as random effect showed that the community-level health literacy was significantly associated with frailty (odds ratio [95% confidence interval] = 0.28 [0.08 to 0.96]) after adjusting for the covariates.
Not only high individual-level health literacy but also high community-level health literacy is associated with a low prevalence of frailty in community-dwelling older adults.
我们旨在探究社区水平健康素养（超越个体水平健康素养）是否与社区居住的老年人群中衰弱的低患病率相关。
一项大型横断面问卷调查在日本京都舞鹤市进行，参与者为年龄在 65 岁或以上、未根据日本公共长期护理保险系统被认定为“支持”或“护理”级别、能够进行基本日常生活活动、且无痴呆或帕金森病的市民。衰弱状况使用 Kihon Checklist 进行评估，得分≥8 表示衰弱。健康素养使用交流和批判健康素养量表进行评估。20 个学区的平均健康素养得分被用作社区水平健康素养指数。我们调查了人口统计学数据和其他潜在的混杂因素，包括教育程度、居住安排、体重指数、合并症、吸烟状况、抑郁症状、社交网络和社区水平协变量。
主要分析包括 6230 名个体（平均年龄 74.3 岁[SD=6.1]）。在每个学区，衰弱的患病率为 21.2-34.2%（平均：26.2%），社区水平健康素养指数为 3.1-3.5（平均：3.4）。包含学区作为随机效应的多水平逻辑回归模型显示，在调整了协变量后，社区水平健康素养与衰弱显著相关（比值比[95%置信区间]=0.28[0.08 至 0.96]）。
不仅个体水平健康素养高，而且社区水平健康素养高与社区居住的老年人群中衰弱的低患病率相关。
