Factors Associated with e-Health Literacy Among Older Adults in Klang Valley, Malaysia: A Cross-Sectional Survey

Background: In recent years, artificial intelligence (AI)-integrated platforms have emerged, providing access to health information and extending beyond information retrieval to include personalized health monitoring and decision support. However, many older adults still have limited digital health literacy, placing them at risk of increased health inequalities and missing opportunities for better health outcomes. Despite the growing importance of digital health information, evidence on eHealth literacy among older adults in Malaysia remains limited, particularly regarding the sociodemographic factors associated with differences in eHealth literacy. Understanding these associations is important for identifying population groups that may be more vulnerable to disparities in accessing, understanding, and evaluating online health information. Therefore, this study aimed to assess the association between eHealth literacy levels and sociodemographic factors among older adults in Klang Valley, Malaysia. Methods: A community survey recruited older adult participants in Klang Valley, Malaysia. An internationally validated instrument, the eHealth Literacy Scale (eHEALS), was used to measure the current eHealth literacy level of older adults. Chi-square tests and bivariate and multivariable logistic regression analyses were conducted to identify factors associated with eHealth literacy. Results: The mean eHEALS score was 27.29 ± 7.61 (range: 8-40), with the majority of participants demonstrating moderate or high perceived eHealth literacy. The bivariate analysis showed that age, ethnicity, education level, pre-retirement occupation, household income, language ability, and English proficiency were significantly associated with eHealth literacy. The multivariable analysis revealed that participants aged 70 years and above and those with a lower income had higher odds of low eHealth literacy (p < 0.05). Conclusions: This study demonstrates that eHealth literacy among older adults in Klang Valley is at a moderate level and is significantly associated with key sociodemographic factors. These findings underscore the need for targeted interventions and inclusive digital health strategies to improve eHealth literacy and reduce health inequalities among older adults in Malaysia.