title: Health literacy and cardiovascular disease risk factors among the elderly: a study from a patient-centered medical home.
abstract: BACKGROUND
  Health literacy (HL) influences the use of healthcare, facilitates comprehension of health risk behaviors and subsequent vulnerabilities, and provides an impetus to seek improved health outcomes with lower cost of care.
  
  
  OBJECTIVE
  To determine the HL level of elderly patients and establish whether an association exists between HL and cardiovascular disease risk factors (CVDRFs).
  
  
  METHODS
  A total of 150 elderly patients seeking care at a patient-centered medical home (PCMH) were administered the Nutritional Literacy Scale (NLS) and Short Test of Functional Health Literacy in Adults (STOFHLA). Sociodemographic, physiological, biochemical, and disease profile data were obtained.
  
  
  RESULTS
  The patients were 68.7% female, 67.3% African American, 4.7% smokers, and 72.5% overweight. They had a mean age of 74.6 years, 13.2 years education, body mass index of 28.9 kg/m2, systolic blood pressure of 138.5 mm Hg, diastolic blood pressure of 70.7 mm Hg, fasting blood glucose of 100.6 mg/dL, and glycated hemoglobin of 6.6%. Their mean lipid values were: total cholesterol (TC), 188.0 mg/dL; high-density lipoprotein cholesterol, 54.3 mg/dL; low-density lipoprotein (LDL) cholesterol, 111.8 mg/dL; and triglycerides, 115.8 mg/dL. The cohort had 88% hypertensives and 32% diabetics. They scored a mean of 20.9 on the NLS and 29.6 on STOFHLA, with 16% lacking adequate scores on both scales. Lower education attainment was linked to higher TC (P = .027) and LDL cholesterol (P = .023), but no association was observed between HL and all the independent CVDRFs evaluated.
  
  
  CONCLUSIONS
  The study shows that a majority of the participating elderly PCMH patients had a higher level of education (≥12 years) and an adequate level of HL. A higher level of education, but not HL, appears to be predictive of a better control of CVDRFs.
authors.affiliation: Division of Geriatric Medicine, Ste 5C, Wayne State University Health Center, 4201 Saint Antoine Dr, Detroit, MI 48201-2153. E-mail: aaranha@med.wayne.edu.
authors.forename: Anil
authors.initials: A
authors.lastname: Aranha
authors.forename: Pragnesh
authors.initials: P
authors.lastname: Patel
authors.forename: Sidakpal
authors.initials: S
authors.lastname: Panaich
authors.forename: Lavoisier
authors.initials: L
authors.lastname: Cardozo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control; D015331:Cohort Studies; D019468:Disease Management; D004522:Educational Status; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D057220:Health Literacy / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D018802:Patient-Centered Care / Q000458:organization & administration*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States