1 in 3 middle-aged adults struggle with basic health tasks

By Stephen Beech

One in three middle-aged adults struggles with basic health tasks, according to new research.

A third of 35- to 64-year-olds have trouble with "everyday" well-being actions such as reading instructions on medicine bottles, suggest the findings.

Researchers found that one in three middle-aged people can't consistently read prescriptions correctly, understand medical forms or recall details from visits to the doctor.

Experts say the skills — referred to as "health literacy" — are critical for managing common conditions such as high blood pressure, high cholesterol and diabetes, which commonly emerge in midlife.

Study lead author Abigail Vogeley said: “We didn't think the problem was going to be this pervasive, but to think that people are reaching their mid to late 30s and 40s, and they haven't been onboarded properly to perform basic personal health tasks is pretty powerful.

“This work is not about pointing out what people can't do, but rather, can we confuse patients less?”

While previous research has found more than half of adults 65 and older have difficulty engaging with the health care system, the new study is the first to focus on middle-aged adults.

Senior author Dr. Michael Wolf, of Northwestern University Feinberg School of Medicine, Chicago, said: "In midlife, there’s no clear ‘user manual’ for engaging with health care.

“Our findings suggest we’re not adequately preparing people to engage and manage their care.”

The study, published in the Journal of General Internal Medicine, included 1,000 adults receiving care at hospitals and health centers throughout Chicago.

To qualify for the study, participants had to have had at least one doctor appointment within the past year or have a visit scheduled in the next six months.

Participants completed interviews and hands-on tasks, such as interpreting prescription labels, recalling doctors' instructions after watching a clinical video in which they were diagnosed with GERD and reviewing written care materials, among other typical health tasks.

Wolf said: “Doctors may ask patients, ‘Are you taking your medicine?’ but we don't ask how they’re taking it, so people might think, ‘I am doing great, I'm taking my medicine,’ but they don't realize they're making mistakes."

The research team assessed health literacy, health self-management and self-reported physical function using a variety of screening tools.

They found 30.5% had limited health literacy skills, while lower health literacy was linked to lower income, less education and unemployment.

Those with poorer skills had more chronic conditions, were prescribed more medications and performed worse on cognitive testing.

Vogeley, a research fellow and neuropsychology doctoral student at Feinberg School of Medicine, said: “Patients differ not just by demographics, but by their ability to manage their care."

The research team recommends simplifying health information using plain language.

They also highlight broader implications for the health system.

Wolf said: “Billions are spent developing drugs, but far less is invested in helping patients use them correctly.

“Improving understanding could significantly improve outcomes and reduce harm.”

Previous research has found that around two-thirds of adults from age 45 to 64 manage at least one chronic condition, with a third managing multiple chronic conditions.

Wolf said: “We just assume people in middle age may know what they are doing when it comes to their health, even though this is a time where chronic conditions start to appear, and they're often delayed in their diagnosis because of how patients variably use health care."

He says that if patients fail to manage chronic conditions properly, it can result in hospital stays and worse health outcomes.

Vogeley added: “The focus has always been on older adults, whom we might assume misdose medications because of cognitive decline, but our findings suggest health literacy is suboptimal even in middle age.

“Middle-aged adults become older adults, so if we look at this from an optimistic perspective, this can be a place for intervention.”