Older patients with cardiovascular diseases exhibit heterogeneous and generally moderate-to-low eHealth literacy, with three distinct latent profiles identified, and education level, Internet use, health information inquiry frequency, physical activity, and perceived social support positively associated with higher literacy categories.
Key Findings
Results
The mean total eHealth literacy score among older cardiovascular patients was moderate-to-low at 25.16 out of a possible range on the Electronic Health Literacy Scale.
Mean total e-HEALS score was 25.16 ± 5.59
Mean score for application ability was 15.59 ± 3.75
Mean score for judgment ability was 6.41 ± 1.52
Mean score for decision-making ability was 3.16 ± 0.96
Survey conducted from November 1, 2025 to April 15, 2026 using convenience sampling at a tertiary A hospital in China with 459 patients
Results
Latent profile analysis identified three distinct eHealth literacy categories among older cardiovascular patients: low, medium, and high.
Low eHealth literacy category comprised 28.3% of patients
Medium eHealth literacy category comprised the largest group at 50.3% of patients
High eHealth literacy category comprised 21.4% of patients
The three categories demonstrated 'significant heterogeneity'
Latent profile analysis was the statistical method used to identify these categories
Results
Higher education level, more frequent Internet use, and higher frequency of health information inquiry were positively associated with medium and high eHealth literacy categories.
Associations were identified through multivariate logistic regression analysis
Univariate analysis was conducted prior to multivariate analysis to screen variables
These factors were positively associated with both the medium and high literacy categories compared to the low category
The study did not report specific odds ratios in the abstract
Results
Regular physical activity and greater perceived social support were positively associated with medium and high eHealth literacy categories.
Both behavioral (physical activity) and social (perceived social support) factors were independently associated with higher eHealth literacy profiles
Associations identified via multivariate logistic regression
These findings highlight social and behavioral dimensions of eHealth literacy beyond purely demographic factors
Results suggest multidimensional interventions targeting individual behaviors and social support may improve eHealth literacy
Results
Advanced age and higher comorbidity burden were negatively associated with medium and high eHealth literacy categories.
Advanced age was negatively associated with being in the medium or high eHealth literacy category
Higher comorbidity burden (measured as number or severity of concurrent conditions) was also negatively associated
These negative associations were identified through multivariate logistic regression controlling for other factors
These findings suggest that the oldest and most medically complex patients face the greatest eHealth literacy challenges
Conclusions
The study identified a need for tailored, multidimensional interventions and disease-specific assessment tools to improve digital health engagement in older cardiovascular patients.
Existing tools may not adequately capture eHealth literacy specific to cardiovascular disease populations
The authors call for development of 'disease-specific assessment tools'
Interventions should address both individual behaviors and social support factors
The goal of interventions should be to 'improve digital health engagement and self-management in this population'
What This Means
This research suggests that older adults with heart and blood vessel diseases in China have generally low-to-moderate ability to find, understand, and use health information online — a skill set called eHealth literacy. Researchers surveyed 459 older patients at a major hospital and used a statistical technique to group them into three distinct types: about 28% had low eHealth literacy, about 50% had medium, and about 21% had high eHealth literacy. This shows that even within this one patient group, there is a wide range of digital health skills, and the majority fall in the lower ranges.
The study found several factors linked to having better eHealth literacy. Patients with higher education, those who used the internet more often, those who frequently looked up health information online, those who exercised regularly, and those who felt they had strong social support were all more likely to fall into the medium or high eHealth literacy groups. On the other hand, being older and having more health conditions at the same time were linked to lower eHealth literacy. These patterns held up even after accounting for other differences between patients.
This research suggests that improving older cardiovascular patients' ability to engage with digital health tools will require more than just teaching computer skills — it will also involve addressing social support networks and encouraging healthy behaviors like physical activity. The authors also point out that current measurement tools may not be well-suited to this specific patient population, and that future efforts should develop tools and programs tailored specifically to older adults managing heart disease.
Xu M, Sun Q, Chen Q, Xia Y. (2026). eHealth literacy in older patients with cardiovascular disease: latent profile analysis and associated factors.. Frontiers in public health. https://doi.org/10.3389/fpubh.2026.1883826