Cognitive function and health literacy are independently associated with heart failure knowledge

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Determine the relationship between cognitive function and health literacy in heart failure (HF) knowledge in patients with HF.


HF requires extensive, complex treatment; thus, cognition and health literacy may contribute to understanding and self-management of HF.


Participants were 330 HF outpatients. Health literacy was assessed using the Medical Term Recognition Test and the Rapid Estimate of Adult Literacy in Medicine. Global cognitive function was screened with the Modified Mini-Mental Status Examination. HF knowledge was assessed with the Dutch Heart Failure Knowledge Scale (DHFKS).


Health literacy (β = .26, p < .001) and cognition (β = .36, p < .001) were related to DHFKS. Both scores were independently associated with DHFKS (health literacy: β = .13, p = .044 and cognition: β = .30, p < .001).


Impairments in health literacy and cognition were independently associated with reduced HF knowledge. Interventions should address both factors to be maximally effective.

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