Background Health literacy is the ability to find, understand, assess, and apply health information. Individuals suffering from multiple chronic conditions have complex healthcare needs that may challenge their health literacy skills. This study aimed to investigate the relationship between multimorbidity, the number of chronic conditions, and health literacy levels in a sample of adults aged 58+ in Switzerland. Methods We used data from 1,615 respondents to a paper-and-pencil questionnaire administered as part of wave 8 (2019/2020) of the Survey of Health, Ageing and Retirement in Europe (SHARE) in Switzerland. Health literacy was measured using the short version of the European Health Literacy Survey questionnaire. The final score ranged from 0 to 16 and was categorised into three health literacy levels: inadequate (0–8), problematic (9–12), and sufficient (13–16). The number of chronic conditions was self-reported based on a pre-defined list. Associations were examined using multivariable ordinary least squares and ordered probit regression models, controlling for key socio-demographic characteristics. Results Overall, 63.5% of respondents reported having at least one chronic condition. Respondents who reported one, two, and three or more chronic conditions were more likely to have lower health literacy scores compared to respondents who did not report any chronic condition (p<0.05, p<0.01, and p<0.001, respectively). Suffering from two and three or more chronic conditions (vs. no chronic condition) was significantly associated with a higher likelihood of having inadequate or problematic health literacy levels (both p-values <0.01). Conclusions Our findings suggest a need to improve health literacy in older adults suffering from chronic conditions. Improved health literacy could constitute a promising lever to empower individuals to better self-manage their health to ultimately reduce the double burden of chronic diseases and insufficient health literacy in this vulnerable population.
The present study investigates the processing of presuppositions across the life span and extends the findings of the only available study on presupposition processing and typical aging by Domaneschi and Di Paola (J Pragmat 140:70–87, 2019). In an online and offline task, we investigate the impact of cognitive load during the processing and recovery of two presupposition triggers—definite descriptions and change-of-state verbs—comparing a group of younger adults with a group of older adults. The collected experimental data show that (1) presupposition recovery declines during normal aging, (2) presupposition recovery of change-of-state verbs is more cognitively demanding for older adults than the recovery of definite descriptions, and lastly (3) presupposition recovery for the change-of-state verb begin is more demanding than the change-of-state verb stop. As of today, few works have directly investigated presupposition processing across the life span. To the best of our knowledge, this is the first work revealing that cognitive load directly impacts the recovery of presuppositions across the life span, which in turn suggests an involvement of verbal working memory.
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