Abstract TH903: Health Literacy and Lifestyles in the Italian Adult Population Aged Under and Over 65 Years: a National Survey

Introduction: Health literacy (HL) refers to people’s ability to find, understand, judge, and use health information to take health-related decisions. Hypothesis: This study aims to evaluate the association between HL and lifestyles in the Italian adult population, comparing under (U65) and over (O65) 65 years age groups. Methods: In 2021, within the framework of the WHO network Measuring Population and Organizational Health Literacy (M-POHL), the Italian National Institute of Health conducted a national survey on a representative sample of the general population aged 18+ years (n=3,500; 2,548 U65, 952 O65). A validated 47-item questionnaire was used to collect core HL information, along with 31 items on related factors, including lifestyles. HL items were rated on a 4-point Likert scale (very easy/easy/difficult/very difficult). Percentage of very easy/easy responses was categorized as Inadequate (0–50%), Problematic (51–66%), Sufficient (67–80%), Excellent (81–100%). Inadequate/Problematic groups were merged into ‘Limiting’, Sufficient/Excellent into ‘Not limiting’. Multivariate logistic regression models were elaborated in U65 and O65 to assess the association of dichotomous HL with obesity (BMI≥30 kg/m2), physical activity-PA (intense (5–7 days/week)/not intense (0–4 d/w)), fruit and vegetable diet-FVD (daily/not daily), smoking habit (yes/no), adjusted by sex, age, region, education-ED, and financial deprivation-FD. Results: Prevalence of Limiting HL was significantly higher in O65 than in U65 (68.1% vs 63.3%). In individuals with Limiting HL, smoking, not daily FVD, not intense PA were significantly more frequent in U65 compared to O65 (34.4% vs 20.3%, 61.4% vs 36.5%, 77.1% vs 67.7%, respectively). Low ED was significantly higher in O65 than in U65 (65.9% vs 3.3%). Obesity and severe FD were similar in O65 and U65 (15.1% vs 14.3% and 20.2% vs 21.0%). Not intense PA and not daily FVD were more strongly associated with Limiting HL in U65 (OR=1.45 and 1.42) than in O65 (OR=1.25 and 0.92). Severe FD remained a strong determinant in both groups (OR=3.38 U65 and 3.45 O65), Low ED was associated with Limiting HL only in O65 (OR=1.38). Conclusions: Unhealthy lifestyles (not intense PA, not daily FVD) showed stronger associations with Limiting HL among U65, whereas socioeconomic determinants were more relevant in O65. These findings suggest different vulnerability profiles by age and socio-economic conditions, calling for targeted strategies to strengthen HL.