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Objective <p>This study aimed to examine health literacy levels among community-dwelling older adults and to investigate the associations between health literacy and selected health-related behaviors, including smoking and physical inactivity.</p> Subject and methods <p>Between August 2019 and July 2020, a community-based survey was undertaken in Balikesir, Turkey, involving residents aged 65 years and older living within the city center. Using Epi Info version 7.2, the minimum required sample size was calculated as 1,071, and 1,094 participants were ultimately recruited using multistage sampling. To evaluate the participants’ health literacy capacities, THLS-32 was utilized alongside a structured questionnaire gathering sociodemographic details. Associations were examined using Generalized Estimating Equations (GEE) with cluster-adjusted robust standard errors.</p> Results <p>Overall, 33.8% of participants had problematic-limited / inadequate health literacy. In multivariable GEE analyses, participants aged ≥ 80 years had higher odds of problematic-limited / inadequate health literacy than those aged 65–79 years (OR = 1.70, 95% CI: 1.02–2.85, <i>p</i> = 0.042). Moderate / poor perceived health was also associated with higher odds of problematic-limited / inadequate health literacy (OR = 1.93, 95% CI: 1.26–2.95, <i>p</i> = 0.002), whereas absence of chronic disease was associated with higher odds of problematic-limited / inadequate health literacy (OR = 2.04, 95% CI: 1.39–3.03, <i>p</i> &lt; 0.001). No statistically significant association was observed between health literacy and smoking in the adjusted model. Smoking was independently associated with younger age (65–79 years: OR = 6.00, 95% CI: 2.50-14.37, <i>p</i> &lt; 0.001) and male gender (OR = 5.59, 95% CI: 3.23–9.64, <i>p</i> &lt; 0.001). Physical inactivity was independently associated with problematic-limited / inadequate HL (OR = 6.04, 95% CI: 3.62–10.10, <i>p</i> &lt; 0.001), older age (OR = 2.83, 95% CI: 1.34–5.98, <i>p</i> = 0.007), income equal to or lower than expenditure (OR = 2.90, 95% CI: 1.27–6.62, <i>p</i> = 0.011), absence of chronic disease (OR = 1.97, 95% CI: 1.07–3.63, <i>p</i> = 0.030), and moderate/poor health perception (OR = 2.58, 95% CI: 1.56–4.26, <i>p</i> &lt; 0.001).</p> Conclusion <p>Approximately one-third of older adults had problematic-limited / inadequate health literacy. An independent association was observed between limited HL and a higher probability of being physically inactive. However, health literacy was not independently related to smoking. These findings imply that health literacy may be an important factor underlying differences in physical activity engagement among older adults. Community-based strategies integrating health literacy support and promotion of physical activity may contribute to healthy ageing.</p>

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Associations between health literacy and selected lifestyle behaviors among community-dwelling older adults

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年8月1日

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  • Celalettin Cevik,
  • Hatice Simsek,
  • Ibrahim Kayabek,
  • Geylan Dogan,
  • Gizem Ay

摘要

Objective

This study aimed to examine health literacy levels among community-dwelling older adults and to investigate the associations between health literacy and selected health-related behaviors, including smoking and physical inactivity.

Subject and methods

Between August 2019 and July 2020, a community-based survey was undertaken in Balikesir, Turkey, involving residents aged 65 years and older living within the city center. Using Epi Info version 7.2, the minimum required sample size was calculated as 1,071, and 1,094 participants were ultimately recruited using multistage sampling. To evaluate the participants’ health literacy capacities, THLS-32 was utilized alongside a structured questionnaire gathering sociodemographic details. Associations were examined using Generalized Estimating Equations (GEE) with cluster-adjusted robust standard errors.

Results

Overall, 33.8% of participants had problematic-limited / inadequate health literacy. In multivariable GEE analyses, participants aged ≥ 80 years had higher odds of problematic-limited / inadequate health literacy than those aged 65–79 years (OR = 1.70, 95% CI: 1.02–2.85, p = 0.042). Moderate / poor perceived health was also associated with higher odds of problematic-limited / inadequate health literacy (OR = 1.93, 95% CI: 1.26–2.95, p = 0.002), whereas absence of chronic disease was associated with higher odds of problematic-limited / inadequate health literacy (OR = 2.04, 95% CI: 1.39–3.03, p < 0.001). No statistically significant association was observed between health literacy and smoking in the adjusted model. Smoking was independently associated with younger age (65–79 years: OR = 6.00, 95% CI: 2.50-14.37, p < 0.001) and male gender (OR = 5.59, 95% CI: 3.23–9.64, p < 0.001). Physical inactivity was independently associated with problematic-limited / inadequate HL (OR = 6.04, 95% CI: 3.62–10.10, p < 0.001), older age (OR = 2.83, 95% CI: 1.34–5.98, p = 0.007), income equal to or lower than expenditure (OR = 2.90, 95% CI: 1.27–6.62, p = 0.011), absence of chronic disease (OR = 1.97, 95% CI: 1.07–3.63, p = 0.030), and moderate/poor health perception (OR = 2.58, 95% CI: 1.56–4.26, p < 0.001).

Conclusion

Approximately one-third of older adults had problematic-limited / inadequate health literacy. An independent association was observed between limited HL and a higher probability of being physically inactive. However, health literacy was not independently related to smoking. These findings imply that health literacy may be an important factor underlying differences in physical activity engagement among older adults. Community-based strategies integrating health literacy support and promotion of physical activity may contribute to healthy ageing.