The latent profile of health literacy among older adults patients with chronic disease comorbidity and its association with self-management behaviors.

BACKGROUND: Chronic diseases pose a heavy worldwide public health burden. China is both one of the fastest-aging nations and the one with the largest older adults population. Among its older adults, chronic disease comorbidity is highly common and seriously harms both health outcomes and quality of life. Successful disease management requires not just clinical care but also adequate health literacy in everyday settings. Nevertheless, health literacy levels in Chinese older adults continue to be relatively low. Clarifying the different health literacy subgroups among multimorbid older adults individuals and how they relate to self-management behaviors is critical for designing targeted programs and supporting healthy aging. OBJECTIVE: This study sought to uncover latent health literacy classes in older adults with multimorbidity, characterize their features and determinants, and evaluate their link to self-management behaviors. METHODS: A convenience sampling method was used to enroll 302 older adults with multiple chronic conditions at Liaoning Provincial People's Hospital in China from November 2025 to January 2026. The collected data covered sociodemographic variables, Health Literacy Measurement Scale for Chronic Disease Patients scores, and Chronic Disease Self-Management Behavior Scale scores. Latent profile analysis (LPA) was performed with Mplus 8.3, and univariate analyses together with multivariate logistic regression were applied to determine factors linked to health literacy profiles. RESULTS: The average health literacy score was 84.37 ± 15.59. Three distinct classes emerged: "low literacy-limited information comprehension" (18.5%, n = 56), "moderate literacy-physician-dependent communication" (42.6%, n = 129), and "high literacy-autonomous and efficient decision-making" (38.9%, n = 117). According to multivariate logistic regression, sex, age, residence location, education level, Alcohol consumption, and illness duration significantly associated with class belonging. CONCLUSION: Overall, health literacy levels in older multimorbid adults are relatively low in this sample, especially regarding communication and interactive skills. Considerable heterogeneity exists across subgroups, and self-management behaviors differ markedly among the identified profiles. Profile-specific, tiered intervention approaches are necessary to boost health literacy and enhance self-management in this population.