Association of functional health literacy and cognitive ability with self-reported diabetes in the English Longitudinal Study of Ageing: a prospective cohort study
Objectives We investigated whether functional health literacy and cognitive ability were associated with self-reported diabetes.Design Prospective cohort study.Setting Data were from waves 2 (2004–2005) to 7 (2014–2015) of the English Longitudinal Study of Ageing (ELSA), a cohort study designed to b...
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BMJ Publishing Group
2022-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/6/e058496.full |
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| author | Ian J Deary Chloe Fawns-Ritchie Jackie Price |
| author_facet | Ian J Deary Chloe Fawns-Ritchie Jackie Price |
| author_sort | Ian J Deary |
| collection | DOAJ |
| description | Objectives We investigated whether functional health literacy and cognitive ability were associated with self-reported diabetes.Design Prospective cohort study.Setting Data were from waves 2 (2004–2005) to 7 (2014–2015) of the English Longitudinal Study of Ageing (ELSA), a cohort study designed to be representative of adults aged 50 years and older living in England.Participants 8669 ELSA participants (mean age=66.7, SD=9.7) who completed a brief functional health literacy test assessing health-related reading comprehension, and 4 cognitive tests assessing declarative memory, processing speed and executive function at wave 2.Primary outcome measure Self-reported doctor diagnosis of diabetes.Results Logistic regression was used to examine cross-sectional (wave 2) associations of functional health literacy and cognitive ability with diabetes status. Adequate (compared with limited) functional health literacy (OR 0.71, 95% CI 0.61 to 0.84) and higher cognitive ability (OR per 1 SD=0.73, 95% CI 0.67 to 0.80) were associated with lower odds of self-reporting diabetes at wave 2. Cox regression was used to test the associations of functional health literacy and cognitive ability measured at wave 2 with self-reporting diabetes over a median of 9.5 years follow-up (n=6961). Adequate functional health literacy (HR 0.64; 95% CI 0.53 to 0.77) and higher cognitive ability (HR 0.77, 95% CI 0.69 to 0.85) at wave 2 were associated with lower risk of self-reporting diabetes during follow-up. When both functional health literacy and cognitive ability were added to the same model, these associations were slightly attenuated. Additionally adjusting for health behaviours and body mass index fully attenuated cross-sectional associations between functional health literacy and cognitive ability with diabetes status, and partly attenuated associations between functional health literacy and cognitive ability with self-reporting diabetes during follow-up.Conclusions Adequate functional health literacy and better cognitive ability were independently associated with lower likelihood of reporting diabetes. |
| format | Article |
| id | doaj-art-b2f2bf7f78974ea1909ed728921f1dd9 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-b2f2bf7f78974ea1909ed728921f1dd92025-01-24T21:40:11ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2021-058496Association of functional health literacy and cognitive ability with self-reported diabetes in the English Longitudinal Study of Ageing: a prospective cohort studyIan J Deary0Chloe Fawns-Ritchie1Jackie Price2professor of differential psychology3 Division of Psychology, School of Humanities, Social Sciences and Law, University of Dundee, Dundee, UK2Prince Charles Hospital, Merthyr Tidfil, UKObjectives We investigated whether functional health literacy and cognitive ability were associated with self-reported diabetes.Design Prospective cohort study.Setting Data were from waves 2 (2004–2005) to 7 (2014–2015) of the English Longitudinal Study of Ageing (ELSA), a cohort study designed to be representative of adults aged 50 years and older living in England.Participants 8669 ELSA participants (mean age=66.7, SD=9.7) who completed a brief functional health literacy test assessing health-related reading comprehension, and 4 cognitive tests assessing declarative memory, processing speed and executive function at wave 2.Primary outcome measure Self-reported doctor diagnosis of diabetes.Results Logistic regression was used to examine cross-sectional (wave 2) associations of functional health literacy and cognitive ability with diabetes status. Adequate (compared with limited) functional health literacy (OR 0.71, 95% CI 0.61 to 0.84) and higher cognitive ability (OR per 1 SD=0.73, 95% CI 0.67 to 0.80) were associated with lower odds of self-reporting diabetes at wave 2. Cox regression was used to test the associations of functional health literacy and cognitive ability measured at wave 2 with self-reporting diabetes over a median of 9.5 years follow-up (n=6961). Adequate functional health literacy (HR 0.64; 95% CI 0.53 to 0.77) and higher cognitive ability (HR 0.77, 95% CI 0.69 to 0.85) at wave 2 were associated with lower risk of self-reporting diabetes during follow-up. When both functional health literacy and cognitive ability were added to the same model, these associations were slightly attenuated. Additionally adjusting for health behaviours and body mass index fully attenuated cross-sectional associations between functional health literacy and cognitive ability with diabetes status, and partly attenuated associations between functional health literacy and cognitive ability with self-reporting diabetes during follow-up.Conclusions Adequate functional health literacy and better cognitive ability were independently associated with lower likelihood of reporting diabetes.https://bmjopen.bmj.com/content/12/6/e058496.full |
| spellingShingle | Ian J Deary Chloe Fawns-Ritchie Jackie Price Association of functional health literacy and cognitive ability with self-reported diabetes in the English Longitudinal Study of Ageing: a prospective cohort study BMJ Open |
| title | Association of functional health literacy and cognitive ability with self-reported diabetes in the English Longitudinal Study of Ageing: a prospective cohort study |
| title_full | Association of functional health literacy and cognitive ability with self-reported diabetes in the English Longitudinal Study of Ageing: a prospective cohort study |
| title_fullStr | Association of functional health literacy and cognitive ability with self-reported diabetes in the English Longitudinal Study of Ageing: a prospective cohort study |
| title_full_unstemmed | Association of functional health literacy and cognitive ability with self-reported diabetes in the English Longitudinal Study of Ageing: a prospective cohort study |
| title_short | Association of functional health literacy and cognitive ability with self-reported diabetes in the English Longitudinal Study of Ageing: a prospective cohort study |
| title_sort | association of functional health literacy and cognitive ability with self reported diabetes in the english longitudinal study of ageing a prospective cohort study |
| url | https://bmjopen.bmj.com/content/12/6/e058496.full |
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