Limited health literacy increases the likelihood of cognitive frailty among older adults

Abstract

Abstract Background Cognitive frailty is a dual geriatric syndrome that is preventable with lifestyle changes. Lifestyle changes are influenced by literacy level. However, the association between limited health literacy (HL) and cognitive frailty (CF) is yet to be discovered. Objectives This study aims to determine the association between HL and CF among older adults. Methods Data was collected between April 2021 to March 2022 in this cross-sectional study. Citizens aged 60 years and older who can understand Malay and English were selected through purposive sampling from the AGELESS Trial screening sample frame. HLS-M-Q18 was administered to determine HL and CDR, and Fried’s Criteria were used to assess the CF status. Results A total of 757 participants were included in the analysis. 68.2% of the total participants had a limited HL level. The prevalence of CF among older adults with limited HL was 48.2% as compared to those with adequate HL (28.2%) (p < 0.001). Based on the HLS-M-Q18 index scores, the robust group had a higher HL index score than those in the CF group: 36.1 (SD = 10.5) and 33.4 (SD = 8.6), respectively, p < 0.05. In binary logistic regression, limited HL, increasing age, lower income, lower education level and rural locality were associated with the increase of CF occurrence. Older adults with limited HL have 2.6 times higher odds of having CF. Conclusion Approximately two-thirds of multiethnic older adults in the study had limited HL, with those with limited HL has 2.6 times higher odds of having CF. These findings emphasize the importance of addressing HL to improve their health outcomes and well-being.

Keywords

• Health literacy
• Cognitive frailty
• Older adults
• Prevention
• Lifestyle intervention