ArticleJournal of general internal medicine2021
Change in Health Literacy over a Decade in a Prospective Cohort of Community-Dwelling Older Adults.
Article in Journal of general internal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 25 citations in OpenAlex.
- Low musculoskeletal health literacy is associated with inferior outcomes in total shoulder arthroplasty.JSES international · 2026Article
- "Exploring the components of health literacy in older adults: a qualitative content analysis approach".BMC geriatrics · 2026Article
- Addressing complexity: The development and pilot testing of a user-friendly Medicare Part D patient decision aid tool.Journal of managed care & specialty pharmacy · 2025Article
- Mediating Role of Health Literacy in Relationship Between Frailty and Medical Costs in Community-Dwelling Older Adults.Healthcare (Basel, Switzerland) · 2025Article
- Assessing health literacy and diversity within the All of Us Research Program.Journal of the American Medical Informatics Association : JAMIA · 2025Article
- Article
- Article
- Patterns of Change in Parental Health Literacy in Relation to Children's Oral Health.Health literacy research and practice · 2023Article
- Understanding health literacy of deaf persons with hypertension in South Korea: A cross-sectional study.PloS one · 2023Article
- Changes in the health literacy of residents aged 15-69 years in central China: A three-round cross-sectional study.Frontiers in public health · 2023Article
- Do Health Information Sources Influence Health Literacy among Older Adults: A Cross-Sectional Study in the Urban Areas of Western China.International journal of environmental research and public health · 2022Article
- The association of health literacy and postoperative complications after colorectal surgery: A cohort study.American journal of surgery · 2022Article
- Multidimensional health literacy profiles and health-related behaviors in the elderly: A cross-sectional survey.International journal of nursing sciences · 2022Article
- Prospective cross-sectional study on the knowledge and practice of patients visiting outpatient urology clinic in Nigeria on coronavirus disease.The Pan African medical journal · 2022Article
- A Visualized and Scientometric Analysis of Health Literacy Research.Frontiers in public health · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 3 institutions in 3 countries.
Funding
Abstract
backgroundHealth literacy is often viewed as a static trait in longitudinal studies, which may over or underestimate an individual's ability to manage one's health.
objectivesWe sought to examine health literacy over time among older adults using three widely used measures.
designA prospective cohort study.
participantsCommunity-dwelling adults ages 55 to 74 at baseline with at least one follow-up visit (N = 656) recruited from one academic internal medicine clinic and six community health centers in Chicago, IL. MEASURES: Health literacy was measured using the Test of Functional Health Literacy in Adults (TOFHLA), Newest Vital Sign (NVS), and Rapid Estimate of Adult Literacy in Medicine (REALM) at baseline and up to three follow-up time points.
resultsIn unadjusted analyses, significant changes since baseline were found beginning at the second follow-up (mean (M) = 6.0 years, SD = 0.6) for the TOFHLA (M = - 0.9, SD = 0.95, p = 0.049) and the REALM (M = 0.3, SD = 2.5, p = 0.004) and at the last follow-up (M = 8.6 years, SD = 0.5) for the NVS (M = - 0.2, SD = 1.4, p = 0.02). There were non-linear effects of baseline age on TOFHLA and NVS scores over time (piecewise cubic spline p = 0.01 and p < 0.001, respectively) and no effect on REALM scores (B = 0.02, 95% CI - 0.01 to 0.04, p = 0.17) using multivariable mixed-effects linear regression models, controlling for race, education, income, and comorbidity.
conclusionWe found a negative relationship between age and health literacy over time as measured by the TOFHLA and NVS. Health literacy barriers appear to be more prevalent among individuals in later life, when self-care demands are similarly increasing. Clinicians might consider strategies to assess and respond to limited health literacy, particularly among patients 70 and older. REALM performance remained stable over 10 years of follow-up. This questions whether health literacy tools measure the same attribute. Prospective health literacy studies should carefully consider what measures to use, depending on their objective.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.