Relationship Between Odds of Reporting a Fall in the Past Year and Health Literacy Among Community-Dwelling Older Adults in Japan: A Preliminary Cross-Sectional Study.

BACKGROUND/

OBJECTIVES

Research on falls among community-dwelling older adults has revealed limited knowledge regarding health literacy. This study aimed to evaluate health literacy in community-dwelling older adults in Japan and to clarify its relationship with the odds of reporting a fall in the past year.

METHODS

A preliminary cross-sectional study was conducted from January 2024 to May 2025, involving 218 community-dwelling older adults. The study collected data on age, sex, presence of multiple diseases, use of the long-term care insurance system, the Brief-Balance Evaluation Systems Test (Brief-BESTest), the Rapid Dementia Screening Test (RDST), the Communicative and Critical Health Literacy (CCHL) scale, and fall reports in the past year.

RESULTS

After excluding four participants, 214 participants (age, 76.9 ± 6.4 years; 61 men and 153 women) were included in the analysis. Of these, 43 (20.1%) participants had reported a fall. A binary logistic regression analysis was performed, adjusting for confounding factors (age, RDST score, and Brief-BESTest score). The reporting of a fall in the past year (falls/non-falls) was used as the dependent variable, and the CCHL score as the independent variable. The results showed that the CCHL score was associated with the reporting of a fall (odds ratio, 0.61; 95% confidence interval, 0.40-0.93).

CONCLUSIONS

These findings suggest that higher CCHL scores, reflecting better communicative and critical health literacy, are associated with lower odds of reporting a fall. However, because of the cross-sectional design of this study, no causal relationship can be inferred. Future longitudinal studies with larger sample sizes are needed to clarify the temporal relationship between health literacy and falls, examine whether this association is causal, and investigate whether the relationship is linear or whether clinically meaningful threshold effects exist.