Researchers in the U.S. have found that being elderly and being unable to read and understand basic health information is a bad combination.

They say senior citizens who have trouble understanding their doctors die earlier than their peers who were better educated.

According to Dr. David Baker of Northwestern University, who led the research, patients with inadequate literacy skills know less about their diseases and are far more likely to be hospitalized.

Dr. Baker and his colleagues followed 3,260 Medicare patients 65 and older in four U.S. cities over a five year period and found that Medicare clients who were confused by pill bottles or appointment slips were 52 percent more likely to die, especially from heart disease.

Dr. Baker says the figures were not just about higher hospital rates but about a significantly higher mortality rate.

In order to establish the seniors so-called health literacy, they quizzed them on how well they understood prescription bottles, appointment slips and insurance forms.

Prescription bottles saying 'take this medicine on an empty stomach one hour before meals or two hours after' were followed with the question when are you going to eat lunch and at what time are you going to take this medicine?

Baker says even in situations where it was stated 'normal blood sugar is 80 to 130, your blood sugar today is 160, is your blood sugar normal?', a quarter of patients were unable to get this right.

The researchers rated the 25 percent of people who got 55 percent or fewer of the questions right as having inadequate health literacy.

Another 11 percent scored as marginally literate and had a 13 percent higher chance of dying in the six years. 

They say findings remained consistent even when factors such as income and education, were taken into consideration.

The authors say the number of years of school completed is strongly associated with reading fluency and those people with more education tend to have a better capacity to obtain, process and understand basic health information.
They also say inadequate health literacy is associated with less knowledge of chronic disease and worse self-management skills for patients with hypertension, diabetes mellitus, asthma and heart failure.

They suggest widespread improvements in health and health care communication are needed to reduce the association between health literacy and mortality.