Association between community-level health literacy and frailty in community-dwelling older adults. 2023

Kazuki Uemura, and Kamitani Tsukasa, and Atsuya Watanabe, and Hiroshi Okamoto, and Minoru Yamada
Graduate School of Rehabilitation Science, Osaka Metropolitan University, 3-7-30 Habikino, Habikino-City, Osaka, 583-8555, Japan. kuemura@omu.ac.jp.

OBJECTIVE We aimed to investigate whether high community-level health literacy, beyond individual-level health literacy, is associated with a low prevalence of frailty among community-dwelling older adults. METHODS A large cross-sectional questionnaire survey was conducted among citizens in Maizuru City, Kyoto, Japan, aged 65 years or older who were not certified as "support" or "care" level according to Japan's public long-term care insurance system, who could perform basic activities of daily living, and who did not have dementia or Parkinson's disease. Frailty status was assessed using the Kihon Checklist, with a score ≥ 8 indicating frailty. Health literacy was assessed using the Communicative and Critical Health Literacy Scale. The mean health literacy score of 20 school districts was used as the community-level health literacy index. We investigated demographic data and other potential confounding factors, including education, living arrangement, body mass index, comorbidity, smoking status, depressive symptoms, social networks, and community-level covariates. RESULTS The primary analysis included 6230 individuals (mean age = 74.3 years [SD = 6.1]). In each school district, the prevalence of frailty was 21.2-34.2% (mean: 26.2%), and community-level health literacy index was 3.1-3.5 (mean: 3.4). Multilevel logistic regression model including school district as random effect showed that the community-level health literacy was significantly associated with frailty (odds ratio [95% confidence interval] = 0.28 [0.08 to 0.96]) after adjusting for the covariates. CONCLUSIONS Not only high individual-level health literacy but also high community-level health literacy is associated with a low prevalence of frailty in community-dwelling older adults.

UI MeSH Term Description Entries
D007564 Japan A country in eastern Asia, island chain between the North Pacific Ocean and the Sea of Japan, east of the Korean Peninsula. The capital is Tokyo. Bonin Islands
D003430 Cross-Sectional Studies Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time. Disease Frequency Surveys,Prevalence Studies,Analysis, Cross-Sectional,Cross Sectional Analysis,Cross-Sectional Survey,Surveys, Disease Frequency,Analyses, Cross Sectional,Analyses, Cross-Sectional,Analysis, Cross Sectional,Cross Sectional Analyses,Cross Sectional Studies,Cross Sectional Survey,Cross-Sectional Analyses,Cross-Sectional Analysis,Cross-Sectional Study,Cross-Sectional Surveys,Disease Frequency Survey,Prevalence Study,Studies, Cross-Sectional,Studies, Prevalence,Study, Cross-Sectional,Study, Prevalence,Survey, Cross-Sectional,Survey, Disease Frequency,Surveys, Cross-Sectional
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000073496 Frailty A state of increased vulnerability to stressors, following declines in function and reserves across multiple physiologic systems, characterized by MUSCLE WEAKNESS; FATIGUE; slowed motor performance; low physical activity; and unintentional weight loss. Debility,Frailness,Frailty Syndrome,Debilities,Frailties
D000203 Activities of Daily Living The performance of the basic activities of self care, such as dressing, ambulation, or eating. ADL,Chronic Limitation of Activity,Limitation of Activity, Chronic,Activities, Daily Living,Activity, Daily Living,Daily Living Activities,Daily Living Activity,Living Activities, Daily,Living Activity, Daily
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D015577 Geriatric Assessment Evaluation of the level of physical, physiological, or mental functioning in the older population group. Assessment, Geriatric,Assessments, Geriatric,Geriatric Assessments
D016330 Frail Elderly Older adults or aged individuals who are lacking in general strength and are unusually susceptible to disease or to other infirmity. Elderly, Frail,Frail Older Adults,Functionally-Impaired Elderly,Frail Elders,Adult, Frail Older,Adults, Frail Older,Elder, Frail,Elderly, Functionally-Impaired,Elders, Frail,Frail Elder,Frail Older Adult,Functionally Impaired Elderly,Older Adult, Frail,Older Adults, Frail
D057187 Independent Living A housing and community arrangement that maximizes independence and self-determination. Aging in Place,Community Dwelling,Dwelling, Community,Dwellings, Community,Living, Independent
D057220 Health Literacy Degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions. Literacy, Health

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