title: The association between age and health literacy among elderly persons.
abstract: OBJECTIVE
  To examine why older age groups have worse functional health literacy.
  
  
  METHODS
  Home interviews were conducted with community-dwelling elderly persons (n = 2,774) to determine demographics, years of school completed, newspaper reading frequency, chronic diseases, and health status. Participants completed the Short Test of Functional Health Literacy in Adults (S-TOFHLA, range 0-100) and the Mini Mental State Examination (MMSE).
  
  
  RESULTS
  Mean S-TOFHLA scores declined 1.4 points (95% CI 1.3-1.5) for every year increase in age (p < .001). After adjusting for sex, race, ethnicity, and education, the S-TOFHLA score declined 1.3 points (95% CI 1.2-1.4) for every year increase in age. Even after adjustment for performance on the MMSE, the S-TOFHLA score declined 0.9 points (95% CI 0.8-1.0) for every year increase in age (p < .001). Differences in newspaper reading frequency, visual acuity, chronic medical conditions, and health status, did not explain the lower literacy of older participants.
  
  
  CONCLUSIONS
  Functional health literacy was markedly lower among older age groups even after adjusting for differences in MMSE performance, newspaper reading frequency, health status, and visual acuity. Future studies should prospectively examine whether functional literacy declines with age and whether this is explained by declines in cognitive function.
authors.affiliation: Center for Health Care Research and Policy, Case Western Reserve University at MetroHealth Medical Center, Cleveland, Ohio USA. dwb@po.cwru.edu
authors.forename: D W
authors.initials: DW
authors.lastname: Baker
authors.forename: J A
authors.initials: JA
authors.lastname: Gazmararian
authors.forename: J
authors.initials: J
authors.lastname: Sudano
authors.forename: M
authors.initials: M
authors.lastname: Patterson
mesh_terms: D000203:Activities of Daily Living; D000368:Aged / Q000706:statistics & numerical data; D002908:Chronic Disease; D004522:Educational Status; D005260:Female; D005431:Florida; D015577:Geriatric Assessment; D006266:Health Education; D006304:Health Status; D006801:Humans; D016014:Linear Models; D008297:Male; D008609:Mental Status Schedule; D009820:Ohio; D011795:Surveys and Questionnaires; D013781:Texas; D014792:Visual Acuity