200 Section - Development and validation of a novel instrument for evaluating sarcopenia health literacy in older adults

Sarcopenia is a prevalent age-related condition associated with physical disability, frailty, and increased mortality. Effective prevention and management rely heavily on sustained lifestyle behaviors, which in turn require adequate health literacy. However, no validated instrument currently exists to comprehensively assess sarcopenia-specific health literacy. This study aimed to develop and validate the psychometric properties of a novel Sarcopenia Health Literacy scale (Sarco-HL) among older adults.

Design: A cross-sectional study was conducted among community-dwelling adults aged ≥60 years recruited from an outpatient clinic. The Sarco-HL scale was developed on the basis of the European Health Literacy Survey (HLS-EU) framework by expert panels and consisted of 24 items covering four health information-processing competencies (access, understand, appraise, apply) across three health domains (healthcare, disease prevention, health promotion). Expert validity was established through an expert panel and iterative cognitive interviews. Internal consistency was assessed using Cronbach’s alpha, mean inter-item correlation, and corrected item–total correlation. Convergent validity was examined by correlations with years of education and the Exercise Benefits/Barriers Scale (EBBS-C). Discriminant validity was evaluated across age groups and sarcopenia diagnosis status.

Results: A total of 91 participants (mean age 72 years; 66% female) were included. The Sarco-HL demonstrated strong internal consistency across the four competencies (Cronbach’s α = 0.88- 0.94) and overall reliability (α = 0.98). Mean inter-item correlations ranged from 0.55 to 0.73. Sarco-HL scores were moderately correlated with years of education (r = 0.52, p < 0.01) and weakly but significantly correlated with EBBS-C total scores (r = 0.26, p = 0.01). Sarco-HL scores significantly differed across age groups and between participants with and without sarcopenia (p = 0.02 and p < 0.01, respectively). The results supported the scale's convergent and discriminant construct validity.

Conclusion: Our developed 24-item Sarco-HL scale demonstrated good reliability and validity for assessing sarcopenia-related health literacy in older adults.