Limited health literacy and decline in executive function in older adults.
Limited health literacy and decline in executive function in older adults.
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DOI：
10.1080/10810730.2013.825673
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发表时间：
2013
影响因子：
4.4
通讯作者：
Paasche-Orlow MK
中科院分区：
文献类型：
--
作者：
Sequeira SS;Eggermont LH;Silliman RA;Bickmore TW;Henault LE;Winter MR;Nelson K;Paasche-Orlow MK
有限的健康素养与较差的执行功能有关，但由于缺乏纵向研究，有限的健康素养与执行功能下降之间的联系尚未确定。作者旨在通过在一项促进老年人步行的随机对照试验的背景下进行前瞻性队列研究来检验这种联系。参与者是居住在社区的老年人(65岁或以上)，他们在Mini-Cog上得2分或更多，没有抑郁(9个项目的患者健康问卷得分低于15)，并完成了基线和12个月评估(n=226)。健康素养的测量采用成人功能性健康素养的短期测验。在基线和12个月时使用连线测验(TMT)、受控口语词汇联想测验和类别流利性测试测量执行功能。健康素养与每项执行功能测试的12个月下降之间的关联被用多元线性回归进行建模。研究发现，37%的参与者的健康素养有限。有限的健康素养与所有3项执行功能测试的表现下降有关。在完全调整的模型中，与较高的健康素养相比，有限的健康素养与TMT上12个月的表现下降更大相关(p=0.01)。总而言之，健康素养有限的老年人在TMT(一种衡量执行功能的指标)上的分数有更快下降的风险。
Limited health literacy is associated with worse executive function, but the association between limited health literacy and decline in executive function has not been established because of a lack of longitudinal studies. The authors aimed to examine this association by studying a prospective cohort in the setting of a randomized controlled trial to promote walking in older adults. Participants were community-dwelling older adults (65 years of age or older) who scored 2 or more on the Mini-Cog, without depression (score of less than 15 on the 9-item Patient Health Questionnaire), and who completed baseline and 12-month evaluations (n = 226). Health literacy was measured using the Short Test of Functional Health Literacy in Adults. Executive function measured at baseline and 12 months using the Trail Making Test (TMT), Controlled Oral Word Association Test, and Category Fluency. The associations between health literacy and 12-month decline in each test of executive function were modeled using multivariate linear regression. Health literacy was found to be limited in 37% of participants. Limited health literacy was associated with reduced performance on all 3 executive function tests. In fully adjusted models, limited health literacy was associated with greater 12-month decline in performance on the TMT than higher health literacy (p = .01). In conclusion, older adults with limited health literacy are at risk for more rapid decline in scores on the TMT, a measure of executive function.