Effects of Cognitive Functioning and Education on Later-Life Health Numeracy.

INTRODUCTION Previous studies have shown an association between a high health numeracy and good cognitive functioning. OBJECTIVE To investigate the moderation effect of education on this relationship and which brain structures support health numeracy. METHODS We examined 70 healthy older persons (66% females; mean ± SD: age, 75.73 ± 4.52 years; education, 12.21 ± 2.94 years). The participants underwent a T1-weighted 3-T MRI and a neuropsychological assessment including a health numeracy task. Statistical parametric mapping was applied to identify focal changes in cortical thickness throughout the entire brain and to correlate image parameters with behavioral measures. RESULTS Executive functions and mental calculation emerged as predictors of health numeracy (B = 0.22, p 12 years). Health numeracy scores were associated with cortical thickness in the right dorsomedial prefrontal cortex and the right superior temporal gyrus (p = 0.01). CONCLUSIONS Older people with a higher education perform better in health numeracy tasks than those with a lower education. They have access to previously acquired knowledge about ratio concepts and do not need to rely on executive functions and computational skills. This is highly relevant when decisions about health care have to be made.