Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China.
Dr. Stephen Hui Research Centre for Physical Recreation and Wellness, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China.
Front Public Health. 2024 Mar 14;12:1355392. doi: 10.3389/fpubh.2024.1355392. eCollection 2024.
Declining cognitive function (CF) and physical function (PF) relate to poorer health-related quality of life (HRQoL) in older adults. As health literacy (HL) facilitates health information utilization, it may mediate links between functionality and HRQoL appraisals. This study examined HL as an intermediary between joint CF and PF contributions and HRQoL in Hong Kong older adults.
490 older adults aged 50-80 years completed assessments from March to July 2021. Health Literacy Survey Questionnaire Short Form 12 questions (HLS-SF12), Montreal Cognitive Assessment (MoCA), Senior Fitness Test (SFT) and 12-Item Short-Form Health Survey version 2 (SF-12v2) were used to assess HL, CF, PF and HRQoL, respectively. Path analysis tested a model with HL mediating CF/PF predictors and HRQoL outcome.
Results for direct effects indicated that CF significantly associated with PF (β = 0.115, SE = 0.012, < 0.001), PF significantly connected to HL (β = 0.101, SE = 0.022, < 0.001), and HL significantly related to HRQoL (β = 0.457, SE = 0.049, < 0.001). Meanwhile, PF significantly linked to HRQoL directly (β = 0.156, SE = 0.025, < 0.001) as well as indirectly (β = 0.046, 95% CI [0.028, 0.067]). Significant mediating effect of HL was found on the relationship of PF and HRQoL.
Findings confirm CF and PF joint impacts on HL and HRQoL in older adults, elucidating HL's mediating role in translating functionality levels into HRQoL. Fostering enduring health knowledge access may thus buffer effects of age-related declines on well-being. Results can inform interventions leveraging this pathway to promote resilient trajectories.
认知功能（CF）和身体功能（PF）下降与老年人健康相关生活质量（HRQoL）较差有关。由于健康素养（HL）促进健康信息的利用，它可能会调节功能与 HRQoL 评估之间的联系。本研究在香港老年人中检验了 HL 作为 CF 和 PF 共同贡献与 HRQoL 之间的中介因素。
2021 年 3 月至 7 月，490 名 50-80 岁的老年人完成了评估。使用健康素养调查问卷短表 12 题（HLS-SF12）、蒙特利尔认知评估（MoCA）、老年人健康体能测试（SFT）和 12 项简短健康调查量表第 2 版（SF-12v2）分别评估 HL、CF、PF 和 HRQoL。路径分析检验了一个模型，其中 HL 介导 CF/PF 预测因子和 HRQoL 结果。
直接效应的结果表明，CF 与 PF 显著相关（β=0.115，SE=0.012，<0.001），PF 与 HL 显著相关（β=0.101，SE=0.022，<0.001），HL 与 HRQoL 显著相关（β=0.457，SE=0.049，<0.001）。同时，PF 直接（β=0.156，SE=0.025，<0.001）和间接（β=0.046，95%CI[0.028，0.067]）与 HRQoL 相关。HL 在 PF 和 HRQoL 之间的关系中存在显著的中介作用。
研究结果证实了 CF 和 PF 对老年人 HL 和 HRQoL 的共同影响，阐明了 HL 在将功能水平转化为 HRQoL 方面的中介作用。因此，促进对健康知识的持久获取可能会缓冲与年龄相关的衰退对幸福感的影响。研究结果可以为利用这一途径促进有弹性轨迹的干预措施提供信息。
