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KV Echt, RA Schuchard, DG Schroeder; Characterizing Older Adults with High and Low Health Literacy . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3827.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:Functional health literacy, or the ability to read and comprehend health-related materials, declines with aging. This study describes the demographic, visual and cognitive characteristics of individuals aged 65 and older who scored within the adequate (high) or inadequate (low) ranges on the Short Test of Functional Health Literacy in Adults (STOFHLA). Methods:To date, 58 participants, ages 65 to 87 (M=72.88 SD=4.89), have been assessed using the MMSE (gross cognitive functioning), ETDRS (high contrast visual acuity), Pelli-Robson (contrast sensitivity), STOFHLA (health literacy), and a demographic questionnaire. Eleven individuals with low health literacy have completed further visual and cognitive tests including A-Span (working memory), Letter Comparison (perceptual speed), Shipley Vocabulary (crystallized intelligence), Shipley Abstraction (fluid intelligence), Woodcock Johnson (comprehension), MN Read (reading acuity), Pepper (visual skills), HVFA (visual fields), ETDRS (low contrast visual acuity) and PV-16 (color vision). Results:Nearly 20% of the participants had low health literacy. These individuals were primarily African-American (55%), reported household incomes below $15K (55%), had fewer years of education (M=12.50; SD=3.26 vs. M=14.70; SD=4.50), took more prescribed medications (M=5.90; SD=3.91 vs. M=4.90; SD=4.50), and had lower MMSE scores (M=25.36; SD=2.20 vs. M=28.15; SD=1.70) than individuals with high health literacy. Similarly, high contrast visual acuity was better among those with high (M=.14; SD=.23) than low (M=.19; SD=.21) health literacy. Overall, MMSE (r=.59) and contrast sensitivity scores (r=.33) correlated significantly with STOFHLA performance. Results from further testing of the low literacy group suggest relationships between health literacy and perceptual speed (r=-.78), vocabulary (r=.74), abstraction (r=.90), comprehension (r=.70), low contrast visual acuity (r=-.60), reading acuity (r=-.68) and color vision (r=.62). Conclusion:The findings to date suggest that there are demographic, visual and cognitive characteristics that may aid in identifying individuals with compromised ability to read and comprehend health-related text materials and facilitating the development of health literacy interventions. Identification of older adults with low health literacy will help ensure that health information is communicated effectively.
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