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    Low health literacy predicts decline in physical function among older adults: Findings from the LitCog cohort study 
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    Low health literacy predicts decline in physical function among older adults: Findings from the LitCog cohort study

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    Accepted version (61.42Kb)
    Volume
    69
    Pagination
    474 - 480
    DOI
    10.1136/jech-2014-204915
    Journal
    Journal of Epidemiology and Community Health
    Issue
    5
    ISSN
    0143-005X
    Metadata
    Show full item record
    Abstract
    Background: Limited health literacy is associated with worse physical function in cross-sectional studies. We aimed to determine if health literacy is a risk factor for decline in physical function among older adults. Methods: A longitudinal cohort of 529 communitydwelling American adults aged 55-74 years were recruited from an academic general internal medicine clinic and federally qualified health centres in 2008-2011. Health literacy (Newest Vital Sign), age, gender, race, education, chronic conditions, body mass index, alcohol consumption, smoking status and exercise frequency were included in multivariable analyses. The 10-item PROMIS (Patient-Reported Outcomes Measurement Information System) physical function scale was assessed at baseline and follow-up (mean=3.2 years, SD=0.39). Results: Nearly half of the sample (48.2%) had either marginal (25.5%) or low health literacy (22.7%). Average physical function at baseline was 83.2 (SD=16.6) of 100, and health literacy was associated with poorer baseline physical function in multivariable analysis (p=0.004). At follow-up, physical function declined to 81.9 (SD=17.3; p=0.006) and 20.5% experienced a meaningful decline (>0.5 SD of baseline score). In multivariable analyses, participants with marginal (OR 2.62; 95%CI 1.38 to 4.95; p=0.003) and low (OR 2.57; 95%CI 1.22 to 5.44; p=0.013) health literacy were more likely to experience meaningful decline in physical function than the adequate health literacy group. Entering cognitive abilities to these models did not substantially attenuate effect sizes. Health literacy attenuated the relationship between black race and decline in physical function by 32.6%. Conclusions: Lower health literacy increases the risk of exhibiting faster physical decline over time among older adults. Strategies that reduce literacy disparities should be designed and evaluated.
    Authors
    Smith, SG; O'Conor, R; Curtis, LM; Waite, K; Deary, IJ; Paasche-Orlow, M; Wolf, MS
    URI
    http://qmro.qmul.ac.uk/xmlui/handle/123456789/11577
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    • Centre for Tumour Biology [310]
    Copyright statements
    Copyright Article author (or their employer) 2015. Produced by BMJ Publishing Group Ltd under licence.
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