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- Title
Cognition and health literacy in patients with hypertension.
- Authors
Levinthal, Brian R.; Morrow, Daniel G.; Wanzhu Tu; Jingwei Wu; Murray, Michael D; Tu, Wanzhu; Wu, Jingwei
- Abstract
<bold>Background: </bold>Approximately half of the US population has marginal or inadequate health literacy, a measure highly associated with health outcomes. This measure is often linked to age and education, but recent evidence from patients with chronic heart failure suggests that much of age-related variability in health literacy can be explained by cognitive abilities (e.g., working memory, processing speed).<bold>Objective: </bold>We examined the role of cognitive and sensory abilities as mediators of age and education in determining functional health literacy among patients with hypertension.<bold>Participants: </bold>Four hundred ninety two community-dwelling adults diagnosed with hypertension (aged 21 to 92 years) participated. They were primarily female (73%), African-American (68%), and reported taking on average 7.8 prescribed medications.<bold>Measurements: </bold>Before participation in a medication adherence intervention study, participants completed a battery of health literacy-related tasks. They completed tests that measured health literacy [Short Test of Functional Health Literacy in Adults (STOFHLA)], cognitive abilities (working memory, processing speed), sensory abilities (visual acuity and hearing), and physical health.<bold>Results: </bold>Regression analyses showed that health literacy was related to age, education, and race (accounting for 24.4% of variance in STOFHLA scores). Cognitive ability accounted for an additional 24% of variance and greatly reduced the influence of age, education, and race (by 75%, 40%, and 48%, respectively).<bold>Conclusions: </bold>When controlling for cognitive and sensory variables, the association of age and education with STOFHLA scores was dramatically reduced. Thus, future interventions aimed at improving self-care for patients with low health literacy should aim to reduce demands on patients' cognitive abilities.
- Subjects
UNITED States; INFLUENCE of age on ability; LITERACY; PATIENTS; HYPERTENSION; COGNITION; HEART failure; ANTIHYPERTENSIVE agents; AUDITORY perception testing; AGE distribution; HEALTH status indicators; REGRESSION analysis; INFORMATION literacy; VISUAL acuity; DRUGS; RESEARCH funding; PATIENT compliance; EDUCATIONAL attainment; COMORBIDITY
- Publication
JGIM: Journal of General Internal Medicine, 2008, Vol 23, Issue 8, p1172
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1007/s11606-008-0612-2