Health Literacy and Frailty in Community-Dwelling Older Adults: Evidence from a Nationwide Cohort Study in South Korea

Int J Environ Res Public Health. 2021 Jul 27;18(15):7918. doi: 10.3390/ijerph18157918.

Abstract

Health literacy is closely associated with poor health outcomes and mortality. However, only a handful of studies have examined the association between health literacy and frailty status. The current study used data from a nationwide sample of Korean adults aged 70-84 collected from 10 cities, each of which represents a different region of South Korea (n = 1521). We used the propensity score matching (PSM) method to minimize the potential selection bias and confounding factors that are present in observational studies. After PSM, demographic and health-related characteristics between the limited health literacy (n = 486) and the nonlimited health literacy (n = 486) groups were not significantly different. Multinomial logistic regression analyses were conducted for the PSM-matched sample to examine the association between health literacy and frailty outcomes, where the robust group was set as a reference. Limited health literacy significantly increased the risk of pre-frailty (RRR = 1.45, p = 0.02) and frailty (RRR = 2.03, p = 0.01) after adjusting for demographic and health-related factors. Our findings underscore the need to foster health literacy programs and provide preliminary evidence to inform tailored intervention programs so that we might attenuate the risk of frailty in the older population.

Keywords: community-dwelling older adults; frailty; health literacy; propensity score matching.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Cross-Sectional Studies
  • Frail Elderly
  • Frailty* / epidemiology
  • Geriatric Assessment
  • Health Literacy*
  • Humans
  • Independent Living
  • Republic of Korea / epidemiology