Relationships between stroke prevalence, health literacy, and oral health-related quality of life in middle-aged and older adults: a national survey study

Abstract

Background Stroke may cause debilitating neurological deficiencies that result in motor, sensory, and cognitive deficits and poorer psychosocial functioning. Prior studies have provided some initial evidence for the significant roles of health literacy and poor oral health for old people. However, few studies have focused on the health literacy of individuals who had a stroke; therefore, the relationships between the health literacy and oral health-related quality of life (OHRQoL) among middle-aged and older adults who had a stroke are unknown. We aimed to assess the relationships between stroke prevalence, health literacy status, and OHRQoL in middle-aged and older adults. Methods We retrieved the data from The Taiwan Longitudinal Study on Aging, a population-based survey. For each eligible subject, we gathered data in 2015 on age, sex, level of education, marital status, health literacy, the activity daily living (ADL), stroke history and OHRQoL. We evaluated the respondents’ health literacy by using a nine-item health literacy scale and categorized their health literacy level as low, medium, or high. OHRQoL was identified based on the Taiwan version of the Oral Health Impact Profile (OHIP-7T). Results The final study contained 7702 community-based dwelling elderly people (3630 male and 4072 female) were analysis in our study. Stroke history was reported in 4.3% of participants, 25.3% reported low health literacy, and 41.9% had at least one ADL disability. Furthermore, 11.3% of participants had depression, 8.3% had cognitive impairment, and 3.4% had poor OHRQoL. Age, health literacy, ADL disability, stroke history, and depression status were significantly associated with poor OHRQoL after sex and marital status was adjusted. Medium (odds ratio [OR] = 1.784, 95% confidence interval [CI] = 1.177, 2.702) to low health literacy (OR = 2.496, 95% CI = 1.628, 3.828) was significantly associated with poor OHRQoL. Conclusions Base our study results, people with stroke history had poor OHRQoL. Lower health literacy and ADL disability were associated with worse QHRQoL. Further studies are necessary to define practical strategies for reducing the risk of stroke and oral health with constantly lower health literacy, thereby improving the quality of life and providing health care of older people.

Status and influential factors of health literacy in patients with ischemic stroke: A cross-sectional study

“…The 2019 Global Burden of Disease showed that stroke is the second leading cause of death and the third leading cause of disability in the world [ 1 , 2 ]. The global cost of stroke is estimated over US$ 891 billion (1.12% of the global gross domestic product) [ 2 , 3 ].…”

“…The 2019 Global Burden of Disease showed that stroke is the second leading cause of death and the third leading cause of disability in the world [ 1 , 2 ]. The global cost of stroke is estimated over US$ 891 billion (1.12% of the global gross domestic product) [ 2 , 3 ]. The “China Stroke Surveillance Report 2021” showed that a total of 3,418,432 stroke cases were admitted in China during 2020, over 80% (81.9%) were ischemic stroke (IS), and the medical cost of hospitalization for stroke in 2020 was CNY 58.0 billion, of which the patient pays approximately CNY 19.8 billion [ 4 ].…”

“…A recent study on cardiovascular and cerebrovascular disease outpatient patients in the United Arab Emirates reported that 39.3% of respondents possessed inadequate HL [ 15 ]. In Taiwan, stroke history was reported in 4.3% of participants, and 25.3% reported low health literacy [ 2 ]. Previous studies have shown that the treatment compliance of stroke patients is related to their health literacy level [ 16 ], and low health literacy may increase the risk of recurrence [ 17 ].…”