Health literacy as a buffer : mitigating the impact of Multimorbidity on functional health in older adults

Abstract

Background

Multimorbidity is a leading cause of functional health impairments in older adults, affecting Activities of Daily Living (ADL). Health-literacy enables individuals to access, process, and apply health-related information effectively, serving as a strategy to mitigate these effects. Aims: This study explores the moderating role of health literacy in the relationship between multimorbidity and functional health according to ADL. Methods

Data were derived from 3069 individuals aged 80 and older from the “Ageing in Germany (D80+)” survey. Multimorbidity was measured using a 22-item index, while health literacy was assessed via a two-item scale evaluating knowledge and compliance. Functional health was determined by ADL performance. Elastic Net regression and moderation analysis were employed to examine the relationships between multimorbidity, health literacy, and functional health, controlling for sociodemographic and mental covariates. Results

Multimorbidity was significantly associated with functional health (b= -1.668, p < 0.001). Health literacy emerged as a significant moderator, attenuating the impact of multimorbidity on functional health (interaction term: b = 0.243, p = 0.023). Conditional effects analysis revealed that individuals with higher health literacy exhibited better functional health, with the adverse effect of multimorbidity on ADL substantially diminished in this group. Discussion

This study highlights the critical role of health literacy in mitigating the impact of multimorbidity on functional health. Interventions aimed at enhancing health literacy offer a promising avenue for promoting independence and functional health in older adults. Conclusion

Future research should focus on longitudinal designs and objective measures to further elucidate the pathways linking multimorbidity, health literacy, and functional health. Fostering the ability to independently obtain, understand and implement health information should be a key goal of clinical practice and policy interventions.