title: Effect of cognitive dysfunction on the relationship between age and health literacy.
abstract: OBJECTIVE
  Age is generally an inverse predictor of health literacy. However, the role of cognitive dysfunction among older adults in this relationship is not understood.
  
  
  METHODS
  We conducted a cross-sectional survey of 446 adult patients in a large urban academic level one trauma center, assessing health literacy and cognitive dysfunction.
  
  
  RESULTS
  Removing older patients (60 years of age and older) who screened positive for cognitive dysfunction attenuated the relationship between age and health literacy (r=-0.16, p=0.001 vs. r=-0.35, p<0.0001). Older patients screening positive for cognitive dysfunction had significantly lower health literacy than older patients screening negative and patients less than 60 years; health literacy scores did not generally differ significantly between the latter groups.
  
  
  CONCLUSIONS
  Much of the relationship between age and health literacy was driven by cognitive dysfunction among a subset of older adults.
  
  
  CONCLUSIONS
  Our findings suggest that older patients with cognitive dysfunction have the greatest need for health literacy interventions.
authors.affiliation: Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, USA. Electronic address: kaphingstk@wudosis.wustl.edu.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Kaphingst
authors.affiliation: Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, USA.
authors.forename: Melody S
authors.initials: MS
authors.lastname: Goodman
authors.affiliation: Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, USA.
authors.forename: William D
authors.initials: WD
authors.lastname: MacMillan
authors.affiliation: Division of Emergency Medicine, Washington University School of Medicine, St. Louis, USA.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Carpenter
authors.affiliation: Division of Emergency Medicine, Washington University School of Medicine, St. Louis, USA.
authors.forename: Richard T
authors.initials: RT
authors.lastname: Griffey
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition; D003072:Cognition Disorders / Q000453:epidemiology*; D032882:Comprehension; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D015577:Geriatric Assessment; D057220:Health Literacy; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D055815:Young Adult
keywords: Age; Cognitive dysfunction; Cognitive status; Health literacy; Patient intervention