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Objective: Health literacy (HL), the ability to understand healthcare information and navigate the healthcare system, is strongly associated with both educational achievement and executive functioning. Many American Indians (AIs) experienced traumatic early education, such as harsh boarding schools, which may impact their educational achievement, and subsequently, HL. Further, AIs disproportionately experience many chronic diseases. This study investigates the relationship between HL and executive functioning in older AIs.

Participants and Methods: Participants were recruited from a southwestern urban area who self-identified as AIs aged 55 to 80 (N=43). Participants were asked to complete questionnaires, interviews, and neuropsychological tests over two sessions. The poster investigates the data from participants who completed both sessions. We created a composite variable of HL measures, (Rapid Estimate of Adult Literacy in Medicine, Newest Vital Sign, and Short Test of Functional Health Literacy in Adults verbal and numeracy z-scores). Executive functioning was assessed by WASI Matrix Reasoning and Similarities, Verbal Semantic Fluency (VSF), and Trails Making – B.

Results: HL was positively correlated with both WASI Matrix Reasoning and WASI Similarities. Similarly, HL was positively correlated with VSF – Animals and Plants. However, there was no significant correlation between HL and VSF – fruits and Vegetables or HL and Trails Making – B.

Conclusions: These findings suggest that HL and executive functioning are linked in older AIs. Discrepancies between the executive functioning tests may be due to resources, culture, and education quality. These findings highlight the need for further investigation of cultural context and development of culturally appropriate measures.


Poster presented at the Brain & Behavioral Health Research Day 2023



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