Limited literacy and mortality in the elderly: the health, aging, and body composition study - PubMed (original) (raw)

Comparative Study

doi: 10.1111/j.1525-1497.2006.00539.x.

Kristine Yaffe, Suzanne Satterfield, Tamara B Harris, Kala M Mehta, Eleanor M Simonsick, Anne B Newman, Caterina Rosano, Ronica Rooks, Susan M Rubin, Hilsa N Ayonayon, Dean Schillinger

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Comparative Study

Limited literacy and mortality in the elderly: the health, aging, and body composition study

Rebecca L Sudore et al. J Gen Intern Med. 2006 Aug.

Abstract

Background: While limited literacy is common and its prevalence increases with age, no prospective study has assessed whether limited literacy is associated with mortality in older adults.

Objective: To assess the association of limited literacy with mortality.

Design and setting: Five-year prospective study from 1999 to 2004 of community-dwelling elders from Memphis, TN, and Pittsburgh, PA, who were from the Health, Aging, and Body Composition study. Subjects' literacy was assessed with the Rapid Estimate of Adult Literacy in Medicine. Scores were categorized into limited (0 to 8th grade reading level) or adequate literacy (> or = 9th grade reading level).

Participants: Two thousand five hundred and twelve black and white elders without baseline functional difficulties or dementia.

Measurements: Time to death.

Results: Participants' mean age was 75.6 years, 48% were male, 38% were black, and 24% had limited literacy; the median follow-up time was 4.2 years. Compared with those with adequate literacy, those with limited literacy had a higher risk of death (19.7% vs 10.6%) with a hazard ratio (HR) of 2.03 (95% confidence intervals [CI], 1.62 to 2.55). After adjusting for demographics and socioeconomic status, co-morbid conditions, self-rated health status, health-related behaviors, health care access measures, and psychosocial status, limited literacy remained independently associated with mortality (HR 1.75; 95% CI, 1.27 to 2.41).

Conclusions: Limited literacy is independently associated with a nearly 2-fold increase in mortality in the elderly. Given the growth of the aging population and the prevalence of chronic diseases, the mechanisms by which limited literacy is associated with mortality in the elderly warrant further investigation.

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Figures

FIGURE 1

FIGURE 1

All-cause mortality by literacy level. Adequate literacy (upper line) is defined by a Rapid Estimate of Adult Literacy in Medicine (REALM) score consistent with ≥9th grade reading level. Limited literacy (lower line) is defined by a REALM score consistent with 0 to eighth grade reading level.

References

    1. Kirsch IS, Jungeblut A, Jenkins L, Kolstad A. [December 3, 2005.]. Adult Literacy in America: A First Look at the Findings of the National Adult Literacy Survey. Washington, DC: Office of Educational Research and Improvement U.S. Department of Education; 1993. Available at: http://nces.ed.gov/pubs93/93275.pdf.
    1. Paasche-Orlow MK, Parker RM, Gazmararian JA, Nielsen-Bohlman LT, Rudd RR. The prevalence of limited health literacy. J Gen Intern Med. 2005;20:175–84. - PMC - PubMed
    1. Williams MV, Parker RM, Baker DW, et al. Inadequate functional health literacy among patients at two public hospitals. JAMA. 1995;274:1677–82. - PubMed
    1. Kalichman SC, Benotsch E, Suarez T, Catz S, Miller J, Rompa D. Health literacy and health-related knowledge among persons living with HIV/AIDS. Am J Prev Med. 2000;18:325–31. - PubMed
    1. Williams MV, Baker DW, Parker RM, Nurss JR. Relationship of functional health literacy to patients' knowledge of their chronic disease. A study of patients with hypertension and diabetes. Arch Intern Med. 1998;158:166–72. - PubMed

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