Cognition and Health Literacy in Patients with Hypertension

Levinthal, Brian R.; Morrow, Daniel G.; Tu, Wanzhu; Wu, Jingwei; Murray, Michael D.

doi:10.1007/s11606-008-0612-2

Cited by 107 publications

(88 citation statements)

References 25 publications

(33 reference statements)

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“…23 In fact, there is a small but growing body of literature documenting associations between measures of literacy, health literacy, and limited sets of cognitive abilities. 15,[24][25][26][27] These studies support the premise that the impact of health literacy on outcomes might be explained by a wide array of cognitive domains. It is imperative to explore these links, as this will expand our thinking on the true nature of the problem, and improve our ability to develop more effective strategies for identifying and responding to individuals who will struggle to learn and apply health information.…”

Section: Objectivesupporting

confidence: 66%

Literacy, Cognitive Function, and Health: Results of the LitCog Study

et al. 2012

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BACKGROUND: Emerging evidence suggests the relationship between health literacy and health outcomes could be explained by cognitive abilities. OBJECTIVE:To investigate to what degree cognitive skills explain associations between health literacy, performance on common health tasks, and functional health status. DESIGN: Two face-to-face, structured interviews spaced a week apart with three health literacy assessments and a comprehensive cognitive battery measuring 'fluid' abilities necessary to learn and apply new information, and 'crystallized' abilities such as background knowledge. SETTING: An academic general internal medicine practice and three federally qualified health centers in Chicago, Illinois. PATIENTS: Eight hundred and eighty-two Englishspeaking adults ages 55 to 74. MEASUREMENTS: Health literacy was measured using the Rapid Estimate of Adult Literacy in Medicine (REALM), Test of Functional Health Literacy in Adults (TOFHLA), and Newest Vital Sign (NVS). Performance on common health tasks were globally assessed and categorized as 1) comprehending print information, 2) recalling spoken information, 3) recalling multimedia information, 4) dosing and organizing medication, and 5) healthcare problem-solving. RESULTS: Health literacy measures were strongly correlated with fluid and crystallized cognitive abilities (range: r=0.57 to 0.77, all p<0.001). Lower health literacy and weaker fluid and crystallized abilities were associated with poorer performance on healthcare tasks. In multivariable analyses, the association between health literacy and task performance was substantially reduced once fluid and crystallized cognitive abilities were entered into models (without cognitive abilities: β=−28.9, 95 % Confidence Interval (CI) -31.4

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Section: Objectivesupporting

confidence: 66%

Literacy, Cognitive Function, and Health: Results of the LitCog Study

et al. 2012

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“…One of the strengths of the numeracy assessment used in this report is that it is brief and does not require a neuropsychologist to administer or interpret it. Previous studies have identified cognitive deficiencies in the CKD and ESRD population (18 -21), and declining cognitive function has been implicated as a potential mediating factor of the lower health literacy documented among the elderly (22,23). Our study suggests a potential relationship between cognitive impairments and numeracy deficiencies in the CKD and ESRD population.…”

Section: Discussionsupporting

confidence: 52%

“…While multiple studies have documented the presence of cognitive deficits in CKD and ESRD (18 -21) and previous findings in patients with hypertension and congestive heart failure have established an association between cognitive performance and health literacy (22,23), there is a gap in our understanding of cognitive performance and numeracy. In this report, we describe the numeracy skills of an outpatient cohort of ESRD and stage 4 to 5 CKD patients assessed using a measure of analytical and statistical numeracy.…”

mentioning

confidence: 99%

Numeracy Skills in CKD

Abdel-Kader

Dew²,

Bhatnagar

et al. 2010

Clinical Journal of the American Society of Nephrology

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Background and objectives: Healthcare providers communicate the risks and benefits of treatments using frequencies, percentages, or proportions. However, many patients lack the numerical skills needed to interpret this information accurately to make informed choices.Design, setting, participants, and measurements: We assessed numeracy, the capacity to use and comprehend numbers, in a prospective cohort study of 187 patients with stage 4 to 5 chronic kidney disease or ESRD. Patients completed a three-item numeracy test and were assessed for global mental status, cognitive function, type of hemodialysis access, and kidney transplant use. We examined the association of numeracy with healthcare use and other cognitive and sociodemographic variables.Results: Over 50% of patients answered one or fewer numeracy questions correctly. Although African Americans (P ‫؍‬ 0.0001), women (P ‫؍‬ 0.05), and the unemployed (P ‫؍‬ 0.0004) demonstrated lower numeracy skills, numeracy deficits were prevalent in every subgroup. In analyses adjusted for demographics and length of follow-up, higher numeracy was significantly associated with receipt of a transplant or active waiting list status. Numeracy was not associated with dialysis modality or hemodialysis vascular access.Conclusion: Similar to prior findings in the general population, these findings indicate that poor numeracy skills are very common in patients with advanced chronic kidney disease and end-stage renal disease. Additional research is needed to further explore whether poor numeracy is a barrier to receipt of a kidney transplant. Clinicians caring for patients with kidney disease should consider using tools to enhance communication and overcome limited numeracy skills.

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“…In a study by Levinthal, Morrow et al, severity of the disease was significantly related to health literacy [10]. The results obtained by Pandit et al showed health literacy as an important predictor of blood pressure control [11].…”

Section: Introductionmentioning

confidence: 97%

The Relationship between Health Literacy and Hypertension Treatment Control and Follow-up

Darvishpour¹,

Omidi²,

Farmanbar³

2016

CJHR

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Objectives: Hypertension is the most important controllable risk factor for cardiovascular, stroke and kidney diseases. Acquiring health information and proper compliance with medical personnel advice requires high levels of health literacy. Thus, the present study was conducted to determine the relationship between health literacy and hypertension treatment control and follow-up in patients attending rural health centers of Rasht city. Methods:This descriptive cross-sectional study was conducted on 257 patients with hypertension selected according to a multistage random sampling method from all rural health centers of Rasht city. Data collection tools included Short Test of Functional Health Literacy in Adults (STOFHLA), hypertension knowledge, and Charlson Comorbidity Index that were completed by patients. Data were analyzed using Pearson's correlation, regression, and Chi-square tests.Results: Par ticipants' mean age was 55.7 years and their mean health literacy was 68.7%. Health literacy was found significantly related to education level (P<0.001), age (P<0.001), and monthly hypertension control (P<0.001). The main sources of acquiring health info rmation included doctors (38.5%), medical personnel (33.7%), and proper use of medication 94.9%. Conclusion:Patients with adequate health literacy were more successful in control and treatment of their diseases. Doctors and medical personnel were more effective in education than other health information sources. Identifying patients with poor health literacy and providing them with appropriate education can have a major role in promoting community health. TypeOriginal Article

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Cognition and Health Literacy in Patients with Hypertension

Cited by 107 publications

References 25 publications

Literacy, Cognitive Function, and Health: Results of the LitCog Study

Literacy, Cognitive Function, and Health: Results of the LitCog Study

Numeracy Skills in CKD

The Relationship between Health Literacy and Hypertension Treatment Control and Follow-up

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