Association between low functional health literacy and mortality in older adults: longitudinal cohort study
Association between low functional health literacy and mortality in older adults: longitudinal cohort study
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DOI：
10.1136/bmj.e1602
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发表时间：
2012-03-15
影响因子：
105.7
通讯作者：
Steptoe, Andrew
中科院分区：
文献类型：
--
作者：
Bostock, Sophie;Steptoe, Andrew
目的探讨功能性健康素养低与健康教育的关系（阅读和理解基本健康相关信息的能力）和老年人死亡率。设计基于分层随机抽样家庭的人口纵向队列研究。设置英格兰。参与者7857名年龄在52岁或以上的成年人参加了第二波（2004-5）英国老龄化纵向研究，并存活超过12个月后采访。参与者完成了一个简短的四项测试的功能性健康素养，其中评估的书面指示采取aspirin tablet.Main结局措施的理解时间死亡，根据所有原因的死亡率，到2009年10月。结果健康素养分为高（最高分，67.2%），中（一个错误，20.3%），或低（一个以上的错误，12.5%）。在随访期间（平均5.3年），发生了621例死亡：321例（6.1%）属于高健康素养类别，143例（9.0%）属于中等类别，157例（16.0%）属于低类别。在调整了个人特征、社会经济地位、基线健康和健康行为后，与健康素养高的参与者相比，健康素养低的参与者全因死亡率的风险比为1.40（95%置信区间为1.15至1.72），健康素养中等的参与者为1.15（0.94至1.41）。认知能力的进一步调整降低了低健康素养的风险比为1.26（1.02至1.55）。结论三分之一的老年人在英格兰有困难阅读和理解基本的健康相关的书面信息。更好的理解与更高的死亡率相关。有限的健康素养的能力在这一人群的影响，为老年人在英格兰的健康相关服务的设计和提供。
Objective To investigate the association between low functional health literacy (ability to read and understand basic health related information) and mortality in older adults.Design Population based longitudinal cohort study based on a stratified random sample of households.Setting England.Participants 7857 adults aged 52 or more who participated in the second wave (2004-5) of the English Longitudinal Study of Ageing and survived more than 12 months after interview. Participants completed a brief four item test of functional health literacy, which assessed understanding of written instructions for taking an aspirin tablet.Main outcome measure Time to death, based on all cause mortality through October 2009.Results Health literacy was categorised as high (maximum score, 67.2%), medium (one error, 20.3%), or low (more than one error, 12.5%). During follow-up (mean 5.3 years) 621 deaths occurred: 321 (6.1%) in the high health literacy category, 143 (9.0%) in the medium category, and 157 (16.0%) in the low category. After adjusting for personal characteristics, socioeconomic position, baseline health, and health behaviours, the hazard ratio for all cause mortality for participants with low health literacy was 1.40 (95% confidence interval 1.15 to 1.72) and with medium health literacy was 1.15 (0.94 to 1.41) compared with participants with high health literacy. Further adjustment for cognitive ability reduced the hazard ratio for low health literacy to 1.26 (1.02 to 1.55).Conclusions A third of older adults in England have difficulties reading and understanding basic health related written information. Poorer understanding is associated with higher mortality. The limited health literacy capabilities within this population have implications for the design and delivery of health related services for older adults in England.