Comprehension of Health-related Written Materials by Older Adults

Abstract

This study examined how Flesch Reading Ease and text cohesion affect older adults' comprehension of common health texts. All older adults benefited when high Flesh Reading Ease was combined with high cohesion. Older adults with small working memories had more difficulty understanding texts high in Flesch Reading Ease. Additionally, older adults with low verbal ability or older than 77 years of age had difficulty understanding texts high in text cohesion but low in Flesch Reading Ease. These results imply that writers must increase Flesch Reading Ease without disrupting text cohesion to ensure comprehension of health-related texts.

This research was supported by grants AG 018892, P30 HD-002528, and P30 DC-005803 from the National Institute of Health and undertaken by the first author in partial fulfillment of the requirements for doctoral degree in Gerontology from the University of Kansas.

Notes

Note. AMNART = The American Version of the Nelson Adult Reading Test. S-TOFHLA = The Short Version of the Test of Functional Health Literacy in Adults.

^a The number of total participants.

^b The number of participants with adequate health literacy only.

Note. ‡p < .001; ∗∗p < .01; ∗p < .05; SE = standard error.

^a Nonzero estimate, 0.0003.

^b 2(log likelihood) based on maximum likelihood (ML) estimation with number of parameters in the parenthesis.

^c Absolute fit indices—a smaller value indicates a better fitting and/or more parsimonious model.