Executive functions are independently associated with health-related numeracy and self-perceived health literacy in applied contexts in healthy adults

Introduction Over a third of U.S. adults struggle with health literacy, which broadly describes the ability to access, understand, and use health-related information. Conceptual models highlight the importance of cognitive functions in health literacy, but limited empirical work has carefully examined the extent to which various aspects of cognition uniquely contribute to different dimensions of health literacy.Method Participants in this retrospective, harmonized study included 312 healthy adults who completed a battery of well-validated cognitive tests that measured their general fund of knowledge, attention, declarative memory, and executive functions (;). Participants also completed a performance-based measure of health-related numeracy (i.e., Expanded Numeracy Scale) and questionnaires assessing self-perceived health literacy in applied contexts (i.e., Brief Health Literacy Screening and eHealth Literacy Scale).Results After accounting for the influence of sociodemographics and general fund of knowledge parallel hierarchical regressions showed that measures of executive functions and memory explained a significant amount of variance in health-related numeracy and measures of executive functions explained a significant, but modest, amount of variance in self-perceived health literacy in applied contexts after accounting for the influence of sociodemographics and general fund of knowledge.Conclusions Findings suggest that executive functions (i.e. generativity and cognitive flexibility) play a unique role in some aspects of personal health literacy among healthy adults. Future experimental studies might further dissect the role of executive functions in the expression and management of health literacy in at-risk clinical populations.