Health Literacy and Associated Factors Among Community-Dwelling Older Adults With Pre-Frailty: A Cross-Sectional Study

Purpose: To assess health literacy levels and identify factors influencing them among community-dwelling older adults with pre-frailty. Method: This cross-sectional study enrolled 254 participants in community health service centers in five cities in Zhejiang Province, China. Health literacy was assessed using the Short-Form Health Literacy Questionnaire. Data were analyzed using descriptive statistics, t tests, analysis of variance, Pearson's correlation analysis, and hierarchical linear regression analysis. Results: Mean age of participants was 72.44 years ( SD = 5.8 years). Mean health literacy index score was 28.72 ( SD = 5.38). Higher health literacy was significantly associated with younger age ( p = .007), higher educational attainment (junior high school: p = .031; senior high school: p = .002; college or higher: p < .001), smart-phone use ( p = .009), regular exercise ( p = .011), and social engagement ( p = .002). Health literacy showed significant negative associations with three or more chronic diseases ( p = .031) and psychological distress ( p < .001). Conclusion: The study revealed significantly low health literacy among older adults with pre-frailty. Health care professionals should adopt targeted interventions focusing on individuals with low health literacy. Future research could develop and evaluate targeted interventions to examine the effects of health promotion on health literacy in community-based populations of older adults with pre-frailty.