Effect of cognitive dysfunction on the relationship between age and health literacy

Patient Educ Couns. 2014 May;95(2):218-25. doi: 10.1016/j.pec.2014.02.005. Epub 2014 Feb 22.


Objective: Age is generally an inverse predictor of health literacy. However, the role of cognitive dysfunction among older adults in this relationship is not understood.

Methods: We conducted a cross-sectional survey of 446 adult patients in a large urban academic level one trauma center, assessing health literacy and cognitive dysfunction.

Results: Removing older patients (60 years of age and older) who screened positive for cognitive dysfunction attenuated the relationship between age and health literacy (r=-0.16, p=0.001 vs. r=-0.35, p<0.0001). Older patients screening positive for cognitive dysfunction had significantly lower health literacy than older patients screening negative and patients less than 60 years; health literacy scores did not generally differ significantly between the latter groups.

Conclusion: Much of the relationship between age and health literacy was driven by cognitive dysfunction among a subset of older adults.

Practice implications: Our findings suggest that older patients with cognitive dysfunction have the greatest need for health literacy interventions.

Keywords: Age; Cognitive dysfunction; Cognitive status; Health literacy; Patient intervention.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living
  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cognition Disorders / epidemiology*
  • Cognition*
  • Comprehension
  • Cross-Sectional Studies
  • Educational Status
  • Female
  • Geriatric Assessment
  • Health Literacy*
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Psychiatric Status Rating Scales
  • Young Adult