Understanding digital health literacy in later life: the role of sociodemographic and health-related factors – a cross-sectional study

Abstract Background So far, digital health literacy (DHL) has been linked to disparities in access to digital tools, differences in usage habits, and varying levels of proficiency in using digital technologies. The aim of the current study was to investigate the link between sociodemographic or health-related factors and digital health literacy among older adults in Germany. Method A total of 3,000 participants from the LIFE Adult Cohort – a population-based cohort study in Germany – aged 65 years and older were re-contacted and surveyed using a paper-and-pencil questionnaire in May 2024. Participation rate was 74%. A sample of n = 2.227 participants was analysed with regard to digital health literacy (revised eHealth Literacy Scale (GR-eHEALS)), sociodemographic and health-related factors (overall health status, chronic diseases and body mass index). In addition, participants were compared regarding their internet use, as well as application of health-related devices and services. Results According to the multivariate regression analysis, digital health literacy (overall and sub-scales) was positively associated with better health status (p < 0.001). Having a chronic disease or long-term health problem, however, as well as BMI-category were not significantly related to DHL. Internet use was the most prominent predictor across all three models (p < 0.001). Being 75 years and older was significantly associated with a decrease in digital health literacy compared to being 65 to 69 years. Moreover, a high educational level (CASMIN) compared to a low level was associated with a 9.3% increase in digital health literacy. Whereas a high income (≥ 3.500 €) compared to an income below 1.500€ was associated with a 7.2% increase in digital health literacy. No significant associations were found with regard to sex or marital status. Conclusion The findings of the current study highlight the importance of sociodemographic and health-related factors in relation to digital health literacy among individuals aged 65 years and older. Further research is needed to clarify these associations in terms of causality and underlying mechanisms in order to develop interventions that focus on older adults in order to improve digital health literacy.