Limited literacy and mortality in the elderly: The health, aging, and body composition study
Limited literacy and mortality in the elderly: The health, aging, and body composition study
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DOI：
10.1111/j.1525-1497.2006.00539.x
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发表时间：
2006-08-01
影响因子：
5.7
通讯作者：
Schillinger, Dean
中科院分区：
文献类型：
--
作者：
Sudore, Rebecca L.;Yaffe, Kristine;Schillinger, Dean
背景：虽然识字能力有限很常见，而且其患病率随着年龄的增长而增加，但没有前瞻性研究评估识字能力有限是否与老年人的死亡率相关。目的：评估识字能力有限与死亡率之间的关系。设计和背景：从 1999 年到 2004 年，对来自田纳西州孟菲斯和宾夕法尼亚州匹兹堡的社区居住老年人进行的五年前瞻性研究，他们来自健康、老龄化和身体成分研究。通过成人医学素养快速评估来评估受试者的素养。分数分为有限（0 至 8 年级阅读水平）或足够识字（>= 9 年级阅读水平）。参与者：2512 名没有基线功能困难或痴呆的黑人和白人长者。测量：死亡时间。结果：参与者的平均年龄为 75.6 岁，48% 是男性，38% 是黑人，24% 识字能力有限；中位随访时间为 4.2 年。与识字能力充足的人相比，识字能力有限的人死亡风险更高（19.7% vs 10.6%），风险比（HR）为2.03（95%置信区间[CI]为1.62至2.55）。在调整人口统计和社会经济状况、共病状况、自评健康状况、健康相关行为、医疗保健获取措施和心理社会状态后，识字率有限仍然与死亡率独立相关（HR 1.75；95% CI，1.27至2.41）。结论：识字率有限与老年人死亡率增加近2倍独立相关。鉴于人口老龄化的增长和慢性病的流行，识字能力有限与老年人死亡率的相关机制值得进一步研究。
Background: While limited literacy is common and its prevalence increases with age, no prospective study has assessed whether limited literacy is associated with mortality in older adults.Objective: To assess the association of limited literacy with mortality.Design and Setting: Five-year prospective study from 1999 to 2004 of community-dwelling elders from Memphis, TN, and Pittsburgh, PA, who were from the Health, Aging, and Body Composition study. Subjects' literacy was assessed with the Rapid Estimate of Adult Literacy in Medicine. Scores were categorized into limited (0 to 8th grade reading level) or adequate literacy (>= 9th grade reading level).Participants: Two thousand five hundred and twelve black and white elders without baseline functional difficulties or dementia.Measurements: Time to death.Results: Participants' mean age was 75.6 years, 48% were male, 38% were black, and 24% had limited literacy; the median follow-up time was 4.2 years. Compared with those with adequate literacy, those with limited literacy had a higher risk of death (19.7% vs 10.6%) with a hazard ratio (HR) of 2.03 (95% confidence intervals [CI], 1.62 to 2.55). After adjusting for demographics and socioeconomic status, co-morbid conditions, self-rated health status, health-related behaviors, health care access measures, and psychosocial status, limited literacy remained independently associated with mortality (HR 1.75; 95% CI, 1.27 to 2.41).Conclusions: Limited literacy is independently associated with a nearly 2-fold increase in mortality in the elderly. Given the growth of the aging population and the prevalence of chronic diseases, the mechanisms by which limited literacy is associated with mortality in the elderly warrant further investigation.