The association of health literacy, numeracy and graph literacy with frailty

Shah, Aakashi; Ferri‐Guerra, Juliana; Nadeem, Mohammed Y; Salguero, Douglas; Aparicio‐Ugarriza, Raquel; Desir, Marianne; Ruiz, Jorge G.

doi:10.1007/s40520-019-01182-x

Cited by 11 publications

(12 citation statements)

References 20 publications

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“…Health literacy was not a direct predictor of frailty, whereas it could impact frailty by intermediating social support and depression. This finding is in accordance with the results of Shah et al who studied male veterans (69). The lack of association of health literacy found in this study compared with existing studies may have arisen owing to differences in the characteristics of the participants.…”

Section: Discussionsupporting

confidence: 92%

The Relationship Between Health Literacy, Social Support, Depression, and Frailty Among Community-Dwelling Older Patients With Hypertension and Diabetes in China

Liu

Meng

et al. 2020

Front. Public Health

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Population aging is one of the major challenges facing modern society and has attracted global attention. With population aging becoming a global phenomenon, the impact of age-related diseases on health is increasing rapidly. Frailty is one of the most pressing issues facing older adults. The purpose of this study was to explore the interrelationship between health literacy, social support, depression, and frailty among older patients with hypertension and diabetes in China. No studies have investigated the mediating effects of social support and depression between health literacy and frailty. The findings of this study can be applied to help ameliorate frailty in older hypertensive and diabetic patients. Data were collected from 637 older hypertensive and diabetic patients aged 65 years and older in Sichuan Province, China. We used structural equation modeling (SEM) to test the hypothesized relationship among the variables. The results showed that 42.4% of the participants suffered from frailty. The mean scores for health literacy, social support, depression, and frailty were 13.6 ± 5.7, 35.7 ± 6.5, 4.0 ± 3.4, and 3.5 ± 2.1, respectively. Social support had a direct negative association with frailty (β = −0.128, 95%CI: [−0.198, −0.056]), and depression had a direct positive association with frailty (β = 0.326, 95%CI: [0.229, 0.411]), while social support had no direct association with depression. Health literacy had a direct positive association with social support (β = 0.151, 95%CI: [0.077, 0.224]) and a direct negative association with depression (β = −0.173, 95%CI: [−0.246, −0.1]), while health literacy had an indirect negative association with frailty through the mediating effect of social support and depression. To mitigate frailty in older patients with hypertension and diabetes, measures that provide social support, and enhance health literacy, while alleviating depression, should be considered, along with greater attention to patients who are divorced, widowed, or unmarried, those with comorbidities, and those with lower socioeconomic status.

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Section: Discussionsupporting

confidence: 92%

The Relationship Between Health Literacy, Social Support, Depression, and Frailty Among Community-Dwelling Older Patients With Hypertension and Diabetes in China

Liu

Meng

et al. 2020

Front. Public Health

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“…The relationships between HL, numeracy literacy, and graph literacy with frailty among male soldiers aged 20 years or older in the U.S. confirmed no evident relationship between HL and frailty [19]. Notable in this study is that despite the average age of the participants being 57 years old, 90% of participants were prefrailty (61.3%) or frailty (28.7%), and 54.9% had inadequate HL [19]. Therefore, frailty and HL should be considered not only for older adults but also for all adult groups.…”

Section: Introductionmentioning

confidence: 74%

“…Several studies have found a relationship between frailty and HL [17][18][19], but these studies were conducted in their own country with the same nationality and only confirmed the relationship between HL and frailty. This study has an implication that it was conducted with minority ethic immigrants in the U.S. who have a totally different cultural and linguistic context.…”

Section: Discussionmentioning

confidence: 92%

“…Generally, immigrants are regarded as vulnerable populations with low HL, resulting in serious health disparities and worsening health outcomes [20,21]. Factors affecting the HL of immigrants were language proficiency, educational attainment, gender, age, and poverty level [19]. Of these, language proficiency is a common limitation among most immigrants.…”

Section: Introductionmentioning

confidence: 99%

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Pathways among Frailty, Health Literacy, Acculturation, and Social Support of Middle-Aged and Older Korean Immigrants in the USA

Sagong

Yoon

2021

IJERPH

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Culturally and linguistically different immigrants in the U.S. are considered populations with low health literacy in general, thereby having a high risk of negative health outcomes such as frailty. The purpose of this study is to identify the effects of social support and acculturation on the relationship between health literacy and frailty of Korean immigrants in existing models of health literacy. A total of 244 Korean immigrants aged 50 years and older residing in Southern United States (Alabama and Georgia) were recruited. Path analysis was used to examine the pathways among variables, and the indirect effects of health literacy were analyzed. The results revealed that health literacy and social support directly influenced frailty; social support and acculturation were identified to influence health literacy. Health literacy had a partial mediating effect in the relationship between social support and frailty and a complete mediating effect in the relationship between acculturation and frailty. Therefore, to prevent frailty, it is necessary to consider enhancing immigrants’ health literacy by elevating acculturation and social supports.

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“…However, only a handful of studies have examined the relationship between health literacy and frailty status [18][19][20][21][22][23][24]. For example, in a study of 603 community-dwelling older adults in Taiwan [18], low health literacy was associated with higher odds of pre-frailty and frailty.…”

Section: Introductionmentioning

confidence: 99%

Health Literacy and Frailty in Community-Dwelling Older Adults: Evidence from a Nationwide Cohort Study in South Korea

Shin

Choi

Kim

et al. 2021

IJERPH

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Health literacy is closely associated with poor health outcomes and mortality. However, only a handful of studies have examined the association between health literacy and frailty status. The current study used data from a nationwide sample of Korean adults aged 70–84 collected from 10 cities, each of which represents a different region of South Korea (n = 1521). We used the propensity score matching (PSM) method to minimize the potential selection bias and confounding factors that are present in observational studies. After PSM, demographic and health-related characteristics between the limited health literacy (n = 486) and the nonlimited health literacy (n = 486) groups were not significantly different. Multinomial logistic regression analyses were conducted for the PSM-matched sample to examine the association between health literacy and frailty outcomes, where the robust group was set as a reference. Limited health literacy significantly increased the risk of pre-frailty (RRR = 1.45, p = 0.02) and frailty (RRR = 2.03, p = 0.01) after adjusting for demographic and health-related factors. Our findings underscore the need to foster health literacy programs and provide preliminary evidence to inform tailored intervention programs so that we might attenuate the risk of frailty in the older population.

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The association of health literacy, numeracy and graph literacy with frailty

Cited by 11 publications

References 20 publications

The Relationship Between Health Literacy, Social Support, Depression, and Frailty Among Community-Dwelling Older Patients With Hypertension and Diabetes in China

The Relationship Between Health Literacy, Social Support, Depression, and Frailty Among Community-Dwelling Older Patients With Hypertension and Diabetes in China

Pathways among Frailty, Health Literacy, Acculturation, and Social Support of Middle-Aged and Older Korean Immigrants in the USA

Health Literacy and Frailty in Community-Dwelling Older Adults: Evidence from a Nationwide Cohort Study in South Korea

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