Proactive planning of care and early identification of older adults with low health literacy and declining cognitive functioning¶

Strategy · All strategies
Evidence · 8 claims (8 for) · 2 studies (2 associational), q3 · 2 of 2 report an effect size · 8 claims rest on one study

Description¶

The article recommends that healthcare professionals engage in proactive planning of care for older adults with both low health literacy and declining cognitive functioning. It states that "Proactive planning of care is essential for older adults with both low health literacy and declining cognitive functioning" and that "early identification of the most vulnerable group is especially important" because cognitive decline is associated with low health literacy even in relatively young older adults.

Design Implications¶

Context¶

Requirements¶

• Healthcare professionals involved in prevention and care for older adults must be aware of the important impact of cognitive functioning on health literacy

Constraints¶

Target Learners¶

• older adults with low health literacy and declining cognitive functioning

Target Learning Goals¶

• health literacy
• person-centered care participation
• health self-management

Claims¶

• Stronger cognitive decline is associated with greater likelihood of low health literacy, but only memory decline remains significant after adjusting for educational level [+W]
• Cognitive decline occurred in all domains between the two measurement waves among participants with cognitive data at both time points [+W]
• Participants with low health literacy had poorer cognitive functioning in all domains and were more often (very) low-educated [+W]
• Poorer current cognitive functioning in all domains is associated with low health literacy in older adults [+W]
• Poorer past cognitive functioning (measured 10 years earlier) is associated with low health literacy in older adults [+W]
• Lower health literacy and weaker cognitive abilities are associated with poorer performance on common healthcare tasks [+W]
• Health literacy measures are strongly correlated with fluid and crystallized cognitive abilities in older adults [+M]
• The association between health literacy and health task performance is substantially reduced after adjusting for cognitive abilities [+W]

Related Strategies¶

Examples¶

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Key Sources¶

• Geboers B, Uiters E, Reijneveld SA, Jansen CJM, Almansa J, Nooyens ACJ, Verschuren WMM, de Winter AF, Picavet HSJ. (2018). Health literacy among older adults is associated with their 10-years' cognitive functioning and decline - the Doetinchem Cohort Study. BMC Geriatrics. https://doi.org/10.1186/s12877-018-0766-7