Lower health literacy linked to becoming homebound
Each one-point lower health literacy score was associated with a 56% higher likelihood of becoming homebound in adults aged 55 to 84.
Our read
Populations- Studied:
- Cohort study of 130,195 adults aged 55 to 84
- What changed:
- Each 1-unit decrease in health literacy score increased the likelihood of becoming homebound by 56%
- The catch:
- Differences in access to care could have contributed to the link
- In the record:
- The 3,771st paper on dementia with results in people; 10,811 on record in all.
Editor of record: Boris Djordjevic · AgingResearch.News
The 130,195 adults aged 55 to 84 in this observational cohort study had records in a statewide electronic health data system covering 2016–2025. The analysis used health literacy scores—the ability to understand and use health information—on a scale from 1 to 5. Researchers used billing codes for home or residence services as a sign of being homebound. They identified 427 people (0.3%) this way.
Each one-point lower health literacy score was associated with a 56% higher likelihood of becoming homebound. In a statistical analysis that considered chronic conditions together, those conditions accounted for 29.9% of the association. Dementia accounted for the largest share. The remaining 70.1% was not explained by the conditions modeled.
Why it matters
Preventing functional decline in older adults was the goal behind the authors’ call for interventions that account for health literacy.
Caveats
Billing codes were a proxy for being homebound and could miss people who did not receive home services. Differences in access to care could also have contributed to the link with health literacy.
- Causal inference
- Health literacy score
- Dementia
- Chronic kidney disease
- Chronic obstructive pulmonary disease
- Humans
The paper
University of Arkansas for Medical Sciences
Journal of General Internal Medicine, Jul 13, 2026
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