The impact of health and financial literacy on decision making in community-based older adults.
The impact of health and financial literacy on decision making in community-based older adults.
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DOI：
10.1159/000339094
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发表时间：
2012
期刊：
影响因子：
3.5
通讯作者：
Bennett DA
中科院分区：
文献类型：
--
作者：
James BD;Boyle PA;Bennett JS;Bennett DA
健康和金融知识与老年人的健康和福祉有关，但很少有数据表明健康和金融知识如何影响老年人的医疗保健和经济选择决策。研究健康和金融知识与老年人决策的关系。数据来自525名社区居住的老年人，他们没有痴呆症，来自拉什记忆和老龄化项目，这是一项正在进行的老龄化纵向研究。通过一系列旨在衡量对健康和财务信息和概念的理解的问题来评估健康和财务知识。将这两个分数取平均值，得出识字总分。使用修改后的12项决策能力评估工具来衡量财务和医疗决策（各6项），使用的材料旨在接近真实的世界环境中使用的材料。所有12个项目的总和产生一个总的决策得分。通过调整年龄、性别和教育程度的线性回归模型对相关性进行了测试。二级模型调整了整体认知功能，收入，抑郁症和慢性疾病。平均而言，参与者正确回答了67%的扫盲问题（健康扫盲= 61.6%，SD = 18.8%，金融扫盲= 72.5%，SD = 16.0%）。调整认知功能后，识字总分与决策总分呈正相关（估计值= 0.64，SE = 0.08，p < 0.001），以及医疗保健（估计值= 0.37，SE = 0.5，p < 0.001）和财务决策（估计值= 0.28，SE = 0.05，p < 0.001）。此外，总识字率，健康和金融知识都与模型中的决策独立相关，这些模型调整了包括收入，抑郁症和慢性疾病在内的协变量（所有p值< 0.001）。最后，有证据表明，影响修改，识字和医疗保健决策之间的有益关联是更强的老年人，穷人和人在较低范围的认知能力。在没有痴呆症的社区老年人中，较高的健康和金融知识水平与更好的决策有关，这表明提高识字率可以促进更好的决策，并导致晚年更好的健康和生活质量。
Health and financial literacy have been linked to the health and well-being of older adults, yet there are few data on how health and financial literacy actually impact decision making regarding healthcare and economic choices in advanced age. To examine the association of health and financial literacy with decision making in older adults. Data came from 525 community-dwelling older persons without dementia from the Rush Memory and Aging Project, an ongoing longitudinal study of aging. Health and financial literacy were assessed via a series of questions designed to measure comprehension of health and financial information and concepts. The two scores were averaged to yield a total literacy score. A modified, 12-item version of the Decision-Making Competence Assessment Tool was used to measure financial and healthcare decision making (6 items each), using materials designed to approximate those used in real world settings. All 12 items were summed to yield a total decision-making score. Associations were tested via linear regression models adjusted for age, sex and education. Secondary models adjusted for global cognitive function, income, depression and chronic medical conditions. On average, participants correctly answered 67% of the literacy questions (health literacy = 61.6%, SD = 18.8% and financial literacy = 72.5%, SD = 16.0%). After adjustment for cognitive function, the total literacy score was positively associated with the decision-making total score (estimate = 0.64, SE = 0.08, p < 0.001), as well as healthcare (estimate = 0.37, SE = 0.5, p < 0.001) and financial decision making (estimate = 0.28, SE = 0.05, p < 0.001). Further, total literacy, health and financial literacy all were independently associated with decision making in models adjusted for covariates including income, depression, and chronic medical conditions (all p values < 0.001). Finally, there was evidence of effect modification such that the beneficial association between literacy and healthcare decision making was stronger among older persons, poorer persons and persons at the lower ranges of cognitive ability. Among community based older persons without dementia, higher levels of health and financial literacy were associated with better decision making, suggesting that improvements in literacy could facilitate better decision making and lead to better health and quality of life in later years.
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影响因子：
5.7
作者：
Glass, TA
通讯作者：
Glass, TA
影响因子：
4.1
作者：
Lusardi, Annamaria;Mitchell, Olivia S.
通讯作者：
Mitchell, Olivia S.
影响因子：
5.7
作者：
Baker, DW;Parker, RM;Clark, WS
通讯作者：
Clark, WS
影响因子：
5.7
作者：
BEISECKER, AE
通讯作者：
BEISECKER, AE
影响因子：
2.8
作者：
Kohout, F J;Berkman, L F;Cornoni-Huntley, J
通讯作者：
Cornoni-Huntley, J