Cognition and health literacy in patients with hypertension

Brian R. Levinthal, Daniel G. Morrow, Wanzhu Tu, Jingwei Wu, Michael Murray

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

BACKGROUND: Approximately half of the US population has marginal or inadequate health literacy, a measure highly associated with health outcomes. This measure is often linked to age and education, but recent evidence from patients with chronic heart failure suggests that much of age-related variability in health literacy can be explained by cognitive abilities (e.g., working memory, processing speed). OBJECTIVE: We examined the role of cognitive and sensory abilities as mediators of age and education in determining functional health literacy among patients with hypertension. PARTICIPANTS: Four hundred ninety two community-dwelling adults diagnosed with hypertension (aged 21 to 92 years) participated. They were primarily female (73%), African-American (68%), and reported taking on average 7.8 prescribed medications. MEASUREMENTS: Before participation in a medication adherence intervention study, participants completed a battery of health literacy-related tasks. They completed tests that measured health literacy [Short Test of Functional Health Literacy in Adults (STOFHLA)], cognitive abilities (working memory, processing speed), sensory abilities (visual acuity and hearing), and physical health. RESULTS: Regression analyses showed that health literacy was related to age, education, and race (accounting for 24.4% of variance in STOFHLA scores). Cognitive ability accounted for an additional 24% of variance and greatly reduced the influence of age, education, and race (by 75%, 40%, and 48%, respectively). CONCLUSIONS: When controlling for cognitive and sensory variables, the association of age and education with STOFHLA scores was dramatically reduced. Thus, future interventions aimed at improving self-care for patients with low health literacy should aim to reduce demands on patients' cognitive abilities.

Original languageEnglish
Pages (from-to)1172-1176
Number of pages5
JournalJournal of General Internal Medicine
Volume23
Issue number8
DOIs
StatePublished - Aug 2008

Fingerprint

Health Literacy
Cognition
Aptitude
Hypertension
Education
Short-Term Memory
Independent Living
Medication Adherence
Health
Self Care
African Americans
Hearing
Visual Acuity
Heart Failure
Regression Analysis

Keywords

  • Aging
  • Health literacy
  • Hypertension
  • Working memory

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Cognition and health literacy in patients with hypertension. / Levinthal, Brian R.; Morrow, Daniel G.; Tu, Wanzhu; Wu, Jingwei; Murray, Michael.

In: Journal of General Internal Medicine, Vol. 23, No. 8, 08.2008, p. 1172-1176.

Research output: Contribution to journalArticle

Levinthal, Brian R. ; Morrow, Daniel G. ; Tu, Wanzhu ; Wu, Jingwei ; Murray, Michael. / Cognition and health literacy in patients with hypertension. In: Journal of General Internal Medicine. 2008 ; Vol. 23, No. 8. pp. 1172-1176.
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