This scoping review aims to map the dimensions encompassing the low health literacy (HL) of older adults, describing their respective causes and consequences. A three-step search strategy was conducted using 16 databases from nine portals and reference lists. Of the 4,259 identified studies, 2,845 were screened and 29 (1%) were included. Studies were published between 1999 and 2021, most of them in English (86.2%), from the American continent (48.3%) and with observational design (86.2%). Four dimensions encompassing the low HL of older adults were mapped: (1) patient dimension, (2) healthcare system dimension, (3) social/economic dimension, and (4) health condition dimension. This review highlights specific dimensions encompassing the low literacy in older adults with evidence about its causes and consequences. These results can guide future research and evidence-based practice involving HL of older adults.
Blancafort AliasS.Monteserín NadalR.MoralI.Roqué FígolsM.Rojano i LuqueX.Coll-PlanasL. (2021). Promoting social capital, self-management and health literacy in older adults through a group-based intervention delivered in low-income urban areas: Results of the randomized trial AEQUALIS. BMC Public Health, 21(1), 84. https://doi.org/10.1186/s12889-020-10094-9
4.
BrachC.KellerD.HernandezL. M.BaurC.ParkerR.DreyerB.SchyveP.LemeriseA.J.SchillingerD. (2012). Ten attributes of health literate health care organizations. Participants in the workgroup on attributes of a health literate organization of the IOM Roundtable on Health Literacy. NAM Perspectives, (June). Discussion Paper, National Academy of Medicine.
5.
ChesserA. K.Keene WoodsN.SmothersK.RogersN. (2016). Health literacy and older adults. Gerontology and Geriatric Medicine, 2, 233372141663049. https://doi.org/10.1177/2333721416630492
6.
ChinJ.MadisonA.GaoX.GraumlichJ. F.Conner-GarciaT.MurrayM. D.Stine-MorrowE. A. L.MorrowD. G. (2015). Cognition and health literacy in older adults’ recall of self-care information. The Gerontologist, 57(2), 261–268. https://doi.org/10.1093/geront/gnv091
7.
ChinJ.PayneB.GaoX.Conner-GarciaT.GraumlichJ. F.MurrayM. D.MorrowD. G.Stine-MorrowE. A. L. (2015). Memory and comprehension for health information among older adults: Distinguishing the effects of domain-general and domain-specific knowledge. Memory, 23(4), 577–589. https://doi.org/10.1080/09658211.2014.912331
8.
Commission on Social Determinants of Health (2008). Closing the gap in a generation: Health equity through action on the social determinants of health (p. 40). World Health organization. https://apps.who.int/iris/handle/10665/44084
9.
DelavarF.PashaeypoorS.NegarandehR. (2020). The effects of self-management education tailored to health literacy on medication adherence and blood pressure control among elderly people with primary hypertension: A randomized controlled trial. Patient Education and Counseling, 103(2), 336–342. https://doi.org/10.1016/j.pec.2019.08.028
10.
DoB. N.NguyenP. -A.PhamK. M.NguyenH. C.NguyenM. H.TranC. Q.DuongT. H.NguyenK. T.PhamT. T. M.HsuM. -H.DuongT. V. (2020). Determinants of health literacy and its associations with health-related behaviors, depression among the older people with and without suspected COVID-19 symptoms: A multi-institutional study. Frontiers in Public Health, 8, 581746. https://doi.org/10.3389/fpubh.2020.581746
11.
EronenJ.PaakkariL.PortegijsE.SaajanahoM.RantanenT. (2021). Health literacy supports active aging. Preventive Medicine, 143, 106330. https://doi.org/10.1016/j.ypmed.2020.106330
12.
GazmararianJ. A. (1999). Health literacy among medicare enrollees in a managed care organization. JAMA, 281(6), 545. https://doi.org/10.1001/jama.281.6.545
13.
GodaA.MurataS.NakanoH.NonakaK.IwaseH.ShiraiwaK.AbikoTAnamiK.HorieJ. (2020). The relationship between subjective cognitive decline and health literacy in healthy community-dwelling older adults. Healthcare, 8(4), 567. https://doi.org/10.3390/healthcare8040567
14.
HesterE. J. (2009). An investigation of the relationship between health literacy and social communication skills in older adults. Communication Disorders Quarterly, 30(2), 112–119. https://doi.org/10.1177/1525740108324040
15.
HochhauserM.BrusovanskyM.SirotinM.BronfmanK. (2019). Health literacy in an Israeli elderly population. Israel Journal of Health Policy Research, 8(1), 61. https://doi.org/10.1186/s13584-019-0328-2
16.
HowickJ.ChalmersI.GlasziouP.GreenhalghT.HeneghanC.LiberatiA.. . .HodgkinsonM. (2011). The Oxford 2011 levels of evidence. [Explanation of the 2011 Oxford Centre for Evidence-Based Medicine (OCEBM) Levels of Evidence (Background Document)]. Oxford Centre for Evidence-Based Medicine. https://www.cebm.ox.ac.uk/resources/levels-of-evidence/ocebm-levels-of-evidence
KimS. H.YuX. (2010). The mediating effect of self-efficacy on the relationship between health literacy and health status in Korean older adults: A short report. Aging & Mental Health, 14(7), 870–873. https://doi.org/10.1080/13607861003801011
19.
LeiteM. T.BattistiI. D. E.BerleziE. M.ScheuerÂ. I. (2008). Elderly urban residents and their family and social support networks. Texto & Contexto – Enfermagem, 17(2), 250–257. https://doi.org/10.1590/S0104-07072008000200005
20.
León-GonzálezR.García-EsquinasE.Paredes-GalánE.Ferrero-MartínezA. I.González-GuerreroJ. L.Hornillos-CalvoM.Menéndez-ColinoR.Torres-TorresI.GalánM. C.Torrente-CarballidoM.Olcoz-ChivaM.Rodríguez-PascualC.Rodríguez-ArtalejoF. (2018). Alfabetización en salud y resultados de salud en pacientes muy ancianos con insuficiencia cardiaca. Revista Española de Cardiología, 71(3), 178–184. https://doi.org/10.1016/j.recesp.2017.05.029
21.
LiuY.XueL.XueH.HouP. (2018). Health literacy, self-care agency, health status and social support among elderly Chinese nursing home residents. Health Education Journal, 77(3), 303–311. https://doi.org/10.1177/0017896917739777
22.
LopezC.KimB., & Sacks, K. (2022). Health Literacy in the United States: Enhancing assessments and reducing disparities. [Health Literacy in the United States: Enhancing Assessments and Reducing Disparities]. http://dx.doi.org/10.2139/ssrn.4182046
23.
Mayo-GambleT. L.MoutonC. (2018). Examining the association between health literacy and medication adherence among older adults. Health Communication, 33(9), 1124–1130. https://doi.org/10.1080/10410236.2017.1331311
24.
MõttusR.JohnsonW.MurrayC.WolfM. S.StarrJ. M.DearyI. J. (2014). Towards understanding the links between health literacy and physical health. Health Psychology, 33(2), 164–173. https://doi.org/10.1037/a0031439
25.
PetersM.GodfreyC.McInerneyP.MunnZ.TricoA.KhalilH. (2020). Chapter 11: Scoping reviews. In AromatarisE.MunnZ. (Eds.), JBI manual for evidence synthesis. JBI. https://doi.org/10.46658/JBIMES-20-12
26.
RomeroS. S.ScortegagnaH.deM.DoringM. (2018). Functional health literacy level and behavior in the health of the elderly. Texto & Contexto – Enfermagem, 27(4), e5230017. https://doi.org/10.1590/0104-07072018005230017
27.
SantosM. I. P.deO.PortellaM. R. (2016). Conditions of functional health literacy of an elderly diabetics group. Revista Brasileira de Enfermagem, 69(1), 156–164. https://doi.org/10.1590/0034-7167.2016690121i
28.
SivakumarH.HanochY.BarnesA. J.FedermanA. D. (2016). Cognition, health literacy, and actual and perceived medicare knowledge among inner-city medicare beneficiaries. Journal of Health Communication, 21(sup2), 155–163. https://doi.org/10.1080/10810730.2016.1193921
29.
SmithC. A.ChangE.GallegoG.BalneavesL. G. (2017). An education intervention to improve health literacy and decision making about supporting self-care among older Australians: A study protocol for a randomised controlled trial. Trials, 18(1), 441. https://doi.org/10.1186/s13063-017-2182-2
SørensenK.BrandH. (2017). Developments and perspectives of health literacy in Europe. Public Health Forum, 25(1), 10–12. https://doi.org/10.1515/pubhef-2016-2175
32.
SouzaJ. G.ApolinarioD.MagaldiR. M.BusseA. L.CamporaF.Jacob-FilhoW. (2014). Functional health literacy and glycaemic control in older adults with type 2 diabetes: A cross-sectional study. BMJ Open, 4(2), e004180. https://doi.org/10.1136/bmjopen-2013-004180
33.
TociE.BurazeriG.JerliuN.SørensenK.RamadaniN.HysaB.BrandH. (2015). Health literacy, self-perceived health and self-reported chronic morbidity among older people in Kosovo. Health Promotion International, 30(3), 667–674. https://doi.org/10.1093/heapro/dau009
34.
TriccoA. C.LillieE.ZarinW.O’BrienK. K.ColquhounH.LevacD.HempelS.AklE. A.ChangC.McGowanJ.StewartL.HartlingL.AldcroftA.WilsonM. G.GarrittyC.LewinS.GodfreyC. M.MacdonaldM. T.LangloisE. V.. . .StrausS. E. (2018). PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Annals of Internal Medicine, 169(7), 467–473. https://doi.org/10.7326/M18-0850
United Nations. (2015, June). Transforming Our World, the 2030 Agenda for Sustainable Development.
37.
van der HeideI.HeijmansM.SchuitA. J.UitersE.RademakersJ. (2015). Functional, interactive and critical health literacy: Varying relationships with control over care and number of GP visits. Patient Education and Counseling, 98(8), 998–1004. https://doi.org/10.1016/j.pec.2015.04.006
38.
VerneyS. P.GibbonsL. E.DmitrievaN. O.KueiderA. M.WilliamsM. W.MeyerO. L.ManlyJ. J.SiscoS. M.MarsiskeM. (2019). Health literacy, sociodemographic factors, and cognitive training in the active study of older adults. International Journal of Geriatric Psychiatry, 34(4), 563–570. https://doi.org/10.1002/gps.5051
39.
VogtD.BerensE. -M.SchaefferD. (2020). Gesundheitskompetenz im höheren Lebensalter. Das Gesundheitswesen, 82(05), 407–412. https://doi.org/10.1055/a-0667-8382
40.
WarrenM.De CarloD.DreerL. E. (2016). Health literacy in older adults with and without low vision. The American Journal of Occupational Therapy, 70(3), 1–7. https://doi.org/https://doi.org/10.5014/ajot.2016.017400
41.
WolfM. S.GazmararianJ. A.BakerD. W. (2007). Health literacy and health risk behaviors among older adults. American Journal of Preventive Medicine, 32(1), 19–24. https://doi.org/10.1016/j.amepre.2006.08.024
42.
ZhangF.OrP. P. -L.ChungJ. W. -Y. (2020). The effects of health literacy in influenza vaccination competencies among community-dwelling older adults in Hong Kong. BMC Geriatrics, 20(1), 103. https://doi.org/10.1186/s12877-020-1504-5
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