Abstract
Health literacy has been reported to have effects on health behavior change and health-related outcomes, but few studies have explored the association between health literacy and frailty. The aim of our study is to investigate the relationships between health literacy and frailty among community-dwelling seniors. This cross-sectional study enrolled 603 community-dwelling older adults (307 women) in residential areas, with a mean age of 70.9 ± 5.82 years. Health literacy was assessed using the Mandarin version of the European Health Literacy Survey Questionnaire. Physical frailty was defined by Fried frailty phenotype. Logistic regression was carried out to determine potential risk factors of frailty. In the multivariate logistic regression model, physical activity (Odds Ratio [OR] 1.47, 95% Confidence Interval [CI] 1.06–2.03) and health literacy (sufficient vs. excellent: OR 2.51, 95% CI 1.32–4.77) were associated with prefrailty and frailty. In subgroup analysis, pre-frailty and frailty were also negatively associated with health literacy in individuals with ‘insufficiently active’ (inadequate vs. excellent: OR 5.44, 95% CI 1.6–18.45) and ‘sufficiently/highly active’ physical activity levels (sufficient vs. excellent: OR 2.41, 95% CI 1.07–5.42). Therefore, in these community-dwelling elderly adults, health literacy was associated with pre-frailty and frailty regardless of age, gender, socio-economic status, and education level.
Highlights
Frailty is a clinical geriatric syndrome in the elderly characterized by high vulnerability and low resilience [1] This geriatric giant is associated with an increased likelihood of worse health outcomes including falls, disability, hospitalization, in institutionalization and mortality [2,3,4,5]
Owing to the complex domains of physical, psychological, socio-economic, and environmental factors linked to frailty, a comprehensive multi-disciplinary and multi-step intervention approach including nutritional support and physical exercise is recommended for treating frail older populations [1]
In the multivariate logistic regression model, physical activity and health literacy remained significantly associated with prefrailty and frailty after adjusting for age, sex, body mass index (BMI), education level, annual income, multiple comorbidities, polypharmacy, depression, and protein intake (Table 3)
Summary
Frailty is a clinical geriatric syndrome in the elderly characterized by high vulnerability and low resilience [1] This geriatric giant is associated with an increased likelihood of worse health outcomes including falls, disability, hospitalization, in institutionalization and mortality [2,3,4,5]. Owing to the complex domains of physical, psychological, socio-economic, and environmental factors linked to frailty, a comprehensive multi-disciplinary and multi-step intervention approach including nutritional support and physical exercise is recommended for treating frail older populations [1]. No studies have explored the association between health literacy and frailty, except for one cross-sectional study which did not control for several confounding factors including diseases, prescription drugs, protein intake and physical activity [12]. We designed the present study to determine whether health literacy is associated with frailty in community-dwelling older adults
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