Assess health literacy (HL) among cognitively normal (CN) older adults (>65years) and those with Mild Cognitive Impairment (MCI) by demographic factors in the UAB Alzheimer’s Disease Research Center (ADRC) clinical cohort.

Data was obtained from National Alzheimer’s Coordinating Center Uniform Data Set 3.0 and the Social and Structural Determinants Influencing Aging and Dementia battery - Calgary Charter for Health Literacy scale (CCHL) of UAB ADRC participants from 2020-2025. Bivariate analyses compared baseline demographic characteristics [sex, age, years of education (YOE)] and HL scores among CN adults (76, 59.38%) and participants with MCI (52, 40.63%) by race. Spearman’s rank correlation examined associations between YOE and HL scores overall and by race within clinical diagnosis groups.

Among the 128 participants, 94 (73.4%) were women, 85 (66.4%) self-identified as African American (AA), mean age was 68.1 (±7.1), mean YOE was 15.2 (±2.5), and mean CCHL was 9.5 (±2.7) indicating moderate HL. Compared to white, AA participants were more likely to have a clinical diagnosis of MCI (X= 13.0170, p= 0.0003), and fewer YOE (Z = 3.89, P= 0.0002). When ascertained by race and cognitive status, AAs were younger (p= 0.0021) and had fewer YOE in the MCI group (p=0.0005). However, there was no significant difference in HL scores by race or clinical diagnosis and no overall significant association between YOE and HL. A significant positive correlation between YOE and HL (p < 0.05) was identified among white CN participants.

Associations are varied between YOE and HL by race and clinical diagnosis. These differences may be driven by specific individual and context level factors such as care – seeking behaviors, disease perceptions, field of study and social support warranting further study.