To analyze the correlation between health literacy and health-related quality of life among the elderly in China.

A multi-stage random sampling method was used to measure the health literacy and health-related quality of life of the participants using short-form health literacy survey questionnaire (HLS-SF12) and the European five-dimensional five-level health scale (EQ-5D-5L), respectively. Health-related quality of life was evaluated by using the health utility value. Spearman’s correlation analysis, tobit regression analysis, and restricted cubic spline were used to analyze the correlation between health literacy and HRQoL in elder adults, and sensitivity analyses were performed by excluding participants with hypertension, diabetes mellitus, dyslipidemia, and overweight and obesity.

A total of 1 147 cases of older adults aged ≥60 years were included, with 581 male cases (50.65%) and the age range of 71-75 years was the most prevalent, with 361 cases (31.47%). The mean level of health literacy was 34 (30, 36) points, and the mean level of health utility value was 0.94 (0.83, 1.00). Spearman correlation analysis found a positive correlation between health literacy and health utility value (r_s=0.370, P<0.001). Tobit regression analysis found a positive correlation between health literacy and health utility value (β=0.007, 95% CI: 0.005-0.008, P<0.001). Restricted cubic spline showed an irregular “right skewed” distribution between health literacy and health utility value after adjusting for confounding factors; The relationship between health literacy and health utility value still existed in the sensitivity analyses of elder adults who excluded participants with hypertension, diabetes, dyslipidemia, and overweight and obesity.

The health literacy level is an influential factor in the health-related quality of life of the elderly, and improving the health literacy of the elderly is conducive to the patients’ beneficial behaviors such as disease prevention and control, health care, and health promotion.