Analysis of current status and potential categories of nutritional literacy in elderly patients with chronic diseases: a single-centre cross-sectional study

Zhitong Wang¹Wenxiu Jiang^2,3Jialin Wang^4*

• ¹People’s Hospital of Deyang City, Deyang, China
• ²Chengdu Medical College, Chengdu, China
• ³Chengdu Medical College The First Affiliated Hospital, Chengdu, China
• ⁴Chengdu University of Traditional Chinese Medicine, Chengdu, China

Objective This study identifies nutritional literacy subgroups and influencing factors among elderly chronic disease patients to develop targeted interventions.Methods 316 elderly chronic disease patients from a tertiary hospital in Deyang, China, were surveyed using standardized scales (General Information, Nutritional Literacy, Chronic Disease Management Self-Efficacy). Latent profile analysis identified nutritional literacy subgroups, with univariate and ordered logistic regression verifying influencing factors. Results A total of 316 valid samples were included, with a nutritional literacy score of 67.50 (51.00, 84.00). Nutritional literacy among elderly patients with chronic diseases was classified into three latent categories: "passive dependent type" (23.1%), "cognitive fluctuation type" (42.4%), and "autonomous management type" (34.5%).Ordered logistic regression showed that younger age groups had 25.64-fold (95% confidence interval [CI]:5.07–129.66 ), 13.93-fold (95% CI: 3.10–62.61), and 9.66-fold (95% CI:2.42–38.54 ) higher odds of better nutritional literacy compared to the reference groupaged ≥90 years.Compared to the highest income group(≥5001 yuan), lower monthly income levels were associated with reduced odds of better nutritional literacy, with odds of 0.13-fold (95% CI: 0.04-0.45), 0.31-fold (95% CI: 0.11-0.91), and 0.25 -fold (95% CI: 0.09-0.64) for the ≤1000 yuan, 1001-3000 yuan, and 3001-5000 yuan brackets,respectively. Smartphone use was associated with 1.96-fold higher odds versus non-users (95% CI: 1.03–3.74), while each unit increase in self-efficacy for chronic disease management was associated with 1.04-fold higher odds (95% CI:1.01–1.07) (all p<0.05). Conclusion Nutritional literacy among elderly patients with chronic diseases is moderately low and heterogeneous, and can be categorized into three latent profiles. Different categories of elderly patients exhibit distinct nutritional characteristics; therefore, interventions should be tailored to each nutritional literacy category to developpersonalized improvement strategies. In particular, more education and support should be provided to "passive dependent type" patients to helpenhance their self-management ability and improve their nutritional status, thereby better managing their chronic diseases and improving their quality of life.However, this single-center convenience sample from one Chinese city limits generalizability due to unaccounted regional/cultural diversity. Future multi-center studies across diverse settings should validate these findings.