Association of eHealth Literacy With Cognitive Function, Frailty, and Functional Status in Hospitalized Geriatric Patients: Cross-Sectional Observational Study

JMIR Hum Factors. 2026 Nov 9;13:e92045. doi: 10.2196/92045.

ABSTRACT

BACKGROUND: The rapid growth of digital health technologies has highlighted the importance of eHealth literacy, which is crucial for navigating health information and tools such as telemedicine and eHealth records. However, older adults often have reservations about digital technologies and face barriers due to cognitive, sensory, and motor impairments, which hinder their ability to effectively use digital health applications. Despite its relevance, research on eHealth literacy in older populations is limited, with a particular gap in understanding how self-assessments of eHealth literacy correlate with health characteristics.

OBJECTIVE: The study seeks to explore eHealth literacy among hospitalized geriatric patients in Germany. The main objective is to evaluate the eHealth literacy level within this particular group and identify the clinical and sociodemographic factors that may influence it.

METHODS: Data from this observational study were analyzed to explore characteristics influencing eHealth literacy in hospitalized geriatric patients. The study included patients aged 60 or older in the Department of Geriatric Medicine at Marien Hospital Herne and enrolled in the standardized early rehabilitation pathway. eHealth literacy was measured using the German version of the eHealth Literacy Scale (GR-eHEALS), a self-assessment tool. Sociodemographic and clinical data, including cognitive function (Montreal Cognitive Assessment [MoCA]), frailty (Clinical Frailty Scale [CFS]), and depression (Depression in Old Age Scale [DIA-S]), were collected. Statistical analyses involved descriptive statistics, t tests, chi-square tests, and regression analyses to examine the relationship between eHealth literacy and various factors. Sociodemographic and clinical data, including cognitive function (MoCA), frailty (CFS), and depression (DIA-S), were collected.

RESULTS: A total of 244 participants (aged 60-97, mean 77.2, SD 6.9 years) were included in the analysis. Participants generally reported an eHealth literacy, with higher scores in “information seeking” (mean 3.64, SD 0.84) compared to “information appraisal” (mean 3.32, SD 0.80). Significant differences in eHealth literacy were observed by age, with older participants scoring lower on both subscales. Frailty was significantly associated with critical appraisal of online health information (B=-1.372, 95% CI -2.554 to -0.189), suggesting that individuals who are frail struggle more with evaluating health information. No significant associations were found with other sociodemographic variables, including MoCA scores, education, or gender.

CONCLUSIONS: While the findings suggest a positive self-reported ability to engage with digital health tools, the selective sample and reliance on self-assessment limit the accuracy of these results. It also emphasizes the need for tailored interventions to support older adults in improving their eHealth literacy, particularly those with higher levels of frailty. Further research, including longitudinal studies and objective assessments, is essential to better understand and address the digital health needs of the geriatric population.

PMID:43002657 | DOI:10.2196/92045