Aging Well

Web-Savvy Older Adults Who Enjoy Culture May Retain “Health Literacy” Better

Here’s one more reason to be glad you’re a “Silver Surfer” who often visits and other sites: Researchers from the University College of London found that regular Internet use helps to maintain health literacy skills, regardless of age related cognitive decline. Beyond that, older people who engage in cultural, civic, and leisure activities when they’re not online may retain health literacy better. The study was study published in November 2014 in the “Journal of Epidemiology & Community.”

The Institute of Medicine defines health literacy as the degree to which a person is able to obtain, understand, and process basic health information and services in order to make appropriate decisions regarding health. Low levels of health literacy among older adults are associated with poorer self-care, particularly of long term conditions, as well as higher than average use of emergency care services, low levels of preventive care, and an overall increased risk of death.

The most important factor governing a decline in health literacy in later years is thought to be dwindling cognitive abilities as a result of aging, which gradually dulls the brain functions involved in active learning and vocabulary.

The researchers assessed the health literacy skills of almost 4,500 adults aged 52 and older, all of whom were taking part in the English Longitudinal Study of Aging (ELSA) between 2004 and 2011.

ELSA is a long term study that began in 2002, involving a representative and random sample of the population in England aged 50 and older.

A release from the publisher explains that information on Internet use and engagement in cultural, civic, and leisure activities was collected every two years. Health literacy was assessed in 2004-5 and again in 2010-11, using a health-related reading comprehension test.

At the start of the study, around three out of four people (73%) had adequate health literacy. After six years, health literacy scores fell by one or more points in around a fifth (19%) of people, regardless of their initial score, while a similar proportion had improved by one or more points.

There was a link between age and declining health literacy, and being non-white, having relatively low wealth, few educational qualifications, and difficulties carrying out routine activities of daily living.

Poorer memory and executive function scores at the start of the study were also linked to greater health literacy decline over the subsequent six years.

Around 40% of the entire sample said they never used the Internet or email, while one in three (32%) said they did so regularly. Similar proportions said they had consistently engaged in civic (35%) and/or leisure (31%) activities over the six year follow-up period.

Almost four out of 10 (39%) said they had regularly engaged in cultural activities, such as going to the cinema, theatre, galleries, concerts or the opera, during this time.

Across all time points, Internet use and engagement in cultural, civic, or leisure, activities were lower among those whose health literacy declined.

After taking account of influential factors, only the links between regular Internet use and engaging in cultural activities remained statistically significant.

But each factor appeared to exert an additive effect, and a combination of all four seemed to afford the best protection against health literacy decline, a finding that was independent of any tailing off in cognitive function.

This is an observational study so no definitive conclusions can be drawn about cause and effect.

But the researchers conclude: “Internet use and engagement in various social activities, in particular cultural activities, appear to help older adults maintain the literacy skills required to self-manage health.”

They add: “The results indicate that health literacy skills are fluid over time, that loss of literacy skills during aging is not inevitable, and that technological and social factors should be understood as influences on literacy skills.”

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