A Role for Health Literacy in Protecting People With Limited English Proficiency Against Falling: A Retrospective, Cohort Study.
Natalie F Douglas, Sarah E Wallace, Chin-I Cheng and 3 others
PMID 39218243WHAT IT FOUND
Limited English proficiency nearly tripled fall odds in rehab.
Inadequate health literacy raised that risk fourfold, while adequate literacy kept risk comparable to English speakers. Language barriers and reading difficulty, not cognition alone, drove falls.
Key findings
01Patients with limited English proficiency had nearly three times the odds of falling compared to English speakers.
02Patients with limited English proficiency and inadequate health literacy had four times the odds of falling, whereas those with adequate health literacy had risk comparable to English speakers.
03Cognitive status, communication ability, and health literacy alone were not significantly related to falls without considering language proficiency.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study design cannot prove that language barriers caused the falls, only that they are associated with them. Data relied on what was recorded in the medical chart, which may miss subtle communication or cognitive issues not captured by the standard screening tools. The sample was drawn from four facilities in similar regions, so results may not apply to other settings. Forty records were excluded due to missing fall data.
Declared interests
The authors declared no conflicts of interest. The study was supported by an NIH grant.
The easy way to misread this
Do not read the high fall rate in patients with limited English proficiency as a sign of cognitive decline. The study found that cognition alone did not predict falls, but language barriers and difficulty reading instructions did.