Financial and health literacy discrepancies with cognition in older adults

Objective: Greater financial and health literacy are associated with better cognition; however, research suggests that some individuals exhibit differences, or discrepancies, in these abilities in old age. We investigated discrepancies between literacy and cognition and factors associated with such discrepancies in older adults without dementia. Method: Participants (N = 714; M^age = 81.4; education: M = 15.4; 75.4% female; 5.2% non-White) from the Rush Memory and Aging Project completed cognitive assessments and a financial and health literacy measure that yielded a total literacy score. Participants were characterized into three groups: (a) total literacy scores that are more than one standard deviation (1 SD) above cognition (L > C), (b) total literacy scores falling more than 1 SD below cognition (L < C), and (c) total literacy within 1 SD of cognition (L = C). Logistic regressions were employed to investigate associations between demographic and psychosocial variables and discrepancy group status. Results: Of the 714 participants, 24% showed significant discrepancies. In fully adjusted models, in reference to the L = C group, male sex was associated with greater odds of being in the L > C group (odds ratio [OR] = 2.32, 95% CI [1.33, 4.03], p = .003) and lower odds of being in the L < C group (OR = 0.31, 95% CI [0.14, 0.66], p = .002), higher income was associated with lower odds of being in either discrepancy group (L < C OR = 0.87, 95% CI [0.79, 0.96], p = .004; L > C OR = 0.86, 95% CI [0.76, 0.96], p = .007), and higher trust was associated with lower odds of being in the L > C group (OR = 0.92, 95% CI [0.85, 0.99], p = .030). Conclusions: Findings support literacy and cognition as partially dissociable constructs and highlight important factors associated with discrepancies between literacy and cognition.