David B Buller, Kim D Reynolds, Julia Berteletti, Kim Massie, Jeff Ashley, Mary Klein Buller, Richard T Meenan
Accuracy of Principal and Teacher Knowledge of School District Policies on Sun Protection in California Elementary Schools
Preventing chronic disease
aimed investigate whether high communitylevel health literacy beyond individuallevel health literacy associated low prevalence frailty among communitydwelling older adults large crosssectional questionnaire survey conducted among citizens maizuru city kyoto japan aged 65 years older certified support care level according japans public longterm care insurance system could perform basic activities daily living dementia parkinsons disease frailty status assessed using kihon checklist score 8 indicating frailty health literacy assessed using communicative critical health literacy scale mean health literacy score 20 school districts used communitylevel health literacy index investigated demographic data potential confounding factors including education living arrangement body mass index comorbidity smoking status depressive symptoms social networks communitylevel covariates primary analysis included 6230 individuals mean age 743 years sd 61 school district prevalence frailty 212342 mean 262 communitylevel health literacy index 3135 mean 34 multilevel logistic regression model including school district random effect showed communitylevel health literacy significantly associated frailty odds ratio 95 confidence interval 028 008 096 adjusting covariates high individuallevel health literacy also high communitylevel health literacy associated low prevalence frailty communitydwelling older adults