This research was conducted by Lindsay C Kobayashi, Jane Wardle and Christian von Wagner at University College London, UK


This study investigated whether various activities protect against health literacy decline during ageing. Health literacy is the mix of functional literacy skills required to successfully manage one's health. Data came from 4,365 English men and women aged over 52 between 2004 and 2011. Results indicated that internet use and social activities, particularly cultural engagement, might assist older adults with maintaining health literacy during ageing.

The study measured health literacy, internet use and social engagement

Health literacy was assessed at the beginning of the study and at the 6-year follow-up stage. With regards to internet use, participants were categorised as ‘never users’, ‘intermittent users’ and ‘consistent users’. Social engagement was rated using an index of ‘social detachment’, which includes a range of civic (i.e. church, politics, charities), leisure (i.e. social/sports clubs) and cultural (i.e. cinema, theatre, galleries/museums) activities. Social engagement was assessed as ‘consistent’, ‘intermittent’ or ‘none’ for each social domain.

A range of social activities protect against cognitive decline

Consistent internet use and engagement in cultural activities were individually associated with helping older adults maintain health literacy. The greater the number of activities engaged in, the greater the protection against health literacy decline regardless of socio-demographic, health-related and cognitive differences between respondents.

The specific contribution of cultural activities

Throughout the study, the authors note that only around a third of respondents reported taking part in civic (35 per cent), leisure (31 per cent) or cultural activities (39 per cent). Strikingly, engagement in cultural activities was lower for those whose health literacy declined than for those that it didn’t. This was likely due to a lack of the intellectually-stimulating activities and cognitive skills that are developed during cultural engagement.

This summary is by Anna Kolliakou, King’s Knowledge Exchange Associate

Title Internet use, social engagement and health literacy decline during ageing in a longitudinal cohort of older English adults
Author(s) Kobayashi, L. C., Wardle, J. & von Wagner, C.
Publication date 2015
Source Journal of Epidemiology & Community Health, Vol 69, Iss 3, pp 278-283
Open Access Link
Author email