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Currently submitted to: JMIR Human Factors

Date Submitted: Jan 23, 2026

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Association of eHealth Literacy with Cognitive Function, Frailty and Functional Status in Hospitalized Geriatric Patients – A cross-sectional observational study

  • Chantal Flemm; 
  • Rainer Wirth; 
  • Sarah El Bataioui; 
  • Diana Daubert; 
  • Ida Sibylle Haussleiter; 
  • Matthias Hermenau; 
  • Jan Dieris-Hirche; 
  • Judith Kuhlmann; 
  • Katharina Kunde; 
  • Ulrike Trampisch; 
  • Bianca Ueberberg; 
  • Horst Christian Vollmar; 
  • Theresa Sophie Busse

ABSTRACT

Background:

The rapid growth of digital health technologies has highlighted the importance of electronic health literacy (eHealth literacy), which is crucial for navigating health information and tools such as telemedicine and electronic health 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 analysed to explore characteristics influencing eHealth literacy in hospitalized geriatric patients. The study included patients aged 60 or older, admitted to the Department of Geriatric Medicine at Marien Hospital Herne, and enrolled in the standardized early rehabilitation pathway. eHealth literacy was measured using the GR-eHEALS, a self-assessment tool. Sociodemographic and clinical data, including cognitive function (Montreal Cognitive Assessment – MoCA), frailty (Clinical Frailty Scale), 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.

Results:

A total of 244 participants (aged 60-97, mean age = 77.2 years) were included in the analysis. Participants generally reported moderate eHealth literacy, with higher scores in "Information Seeking" (mean = 3.64) compared to "Information Appraisal" (mean = 3.32). Significant differences in eHealth literacy were observed by age, with older participants scoring lower on both subscales (p-values between 0.009 and 0.019). Frailty was a significant negative predictor for critical appraisal of online health information (B = -1.372, p = 0.023), suggesting that frail individuals 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 limits the accuracy of these results. The study also emphasizes the need for tailored interventions to support older adults in improving their eHealth literacy, particularly those with higher levels of frailty or cognitive impairment. Further research, including longitudinal studies and objective assessments, is essential to better understand and address the digital health needs of the geriatric population. Clinical Trial: German Clinical Trials Register (DRKS00032931, registered on 29/11/2023). Available from https://drks.de/search/de/trial/DRKS00032931.


 Citation

Please cite as:

Flemm C, Wirth R, El Bataioui S, Daubert D, Haussleiter IS, Hermenau M, Dieris-Hirche J, Kuhlmann J, Kunde K, Trampisch U, Ueberberg B, Vollmar HC, Busse TS

Association of eHealth Literacy with Cognitive Function, Frailty and Functional Status in Hospitalized Geriatric Patients – A cross-sectional observational study

JMIR Preprints. 23/01/2026:92045

DOI: 10.2196/preprints.92045

URL: https://preprints.jmir.org/preprint/92045

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