Association between mobility decline and health literacy in older Japanese adults: Onjuku study

Decline in mobility is a global issue that must be addressed in rapidly aging societies. We aimed to clarify the association between locomotive syndrome (LS), a condition of decreased mobility and health literacy (HL) in community-dwelling Japanese adults aged ≥ 40 years. A descriptive survey was conducted in Onjuku Town, Japan, between 2019 and 2023. The participants performed LS risk tests, including the two-step test, stand-up tests and 25-question geriatric locomotive function scale, to assess mobility. They completed the 14-item health literacy scale to quantify the total HL and functional, communicative and critical HL subscales. Other participant characteristics, such as chronic diseases, bodily pain and physical activity, were also surveyed. The association between LS and HL was assessed using univariate and multivariate logistic regression analyses, adjusted for participant characteristics. We analyzed 492 participants with a median age of 71 years. The total HL score decreased as the LS stage increased, with 56, 54 and 51 points in stages 0, 1 and ≥ 2, respectively (p = 0.004). In the logistic regression analysis, a high total HL score was significantly associated with reduced odds of stage ≥ 2 LS (adjusted odds ratio, 0.95; p < 0.001). Furthermore, functional HL score had an independent association with stage ≥ 2 LS (adjusted odds ratio, 0.88; p = 0.009). Our results suggest that clinicians should provide HL education in addition to known preventive measures, such as promoting physical activity, as a holistic approach to decreased mobility.