{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T10:29:52Z","timestamp":1787567392665,"version":"build-2736575974"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T00:00:00Z","timestamp":1787529600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Health-related knowledge is often considered a prerequisite for health behavior, but knowledge may not always translate into everyday practice. This study examined concordance and directional discrepancies between self-reported health-related knowledge and practice among very old adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed data from 2,919 participants aged 80\u202fyears and older from the nationally representative Old Age in Germany (D80+) study (CATI Module 2). Health-related knowledge and self-reported health-related practice were assessed using ordinal self-report items. A positive knowledge\u2013practice discrepancy was defined as reported knowledge exceeding reported practice. CATI2-calibrated complex-survey descriptive analyses were used to examine knowledge\u2013practice patterns. Complex-survey logistic regression models examined factors associated with the presence of a positive discrepancy, while linear models examined its magnitude as a secondary outcome. Exploratory age-, sex-, and education-adjusted models compared the health, functional, and psychosocial profiles of participants with and without a positive discrepancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Most participants reported the highest category of health-related knowledge (74.2, 95% CI 71.8 to 76.5%) and self-reported practice (73.7, 95% CI 71.3 to 76.0%). Knowledge and practice were concordant in 76.5% of participants (95% CI 74.4 to 78.6%), whereas 12.2% showed a positive knowledge\u2013practice discrepancy (95% CI 10.5 to 13.9%). In fully adjusted complex-survey models, higher internal control experience was associated with lower odds of a positive knowledge\u2013practice discrepancy and with a smaller discrepancy magnitude. In exploratory health-profile analyses, positive discrepancy status was associated with lower ADL and IADL scores, more depressive symptoms, lower life satisfaction, more negative aging experiences, and lower internal control experience; these associations remained significant after false-discovery-rate correction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In very old adults, knowledge and practice were generally concordant, while a minority reported more knowledge than practice. Positive discrepancy status co-occurred with a less favorable functional and psychosocial profile, and internal control experience was the most consistent cross-sectional correlate. Longitudinal and behavior-specific studies are needed to clarify the direction and practical relevance of these associations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1891660","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T09:10:19Z","timestamp":1787562619000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Knowledge\u2013practice concordance and discrepancies in very old adults"],"prefix":"10.3389","volume":"13","author":[{"given":"Aline","family":"Sch\u00f6nenberg","sequence":"first","affiliation":[{"name":"Department of Geriatrics, Jena University Hospital","place":["Jena, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenny M.","family":"Ruttloff","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Jena University Hospital","place":["Jena, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantin G.","family":"Heimrich","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Jena University Hospital","place":["Jena, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tino","family":"Prell","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, Jena University Hospital","place":["Jena, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"319","DOI":"10.1186\/s12913-025-12457-7","article-title":"Health literacy interventions and health literacy-related outcomes for older adults: a systematic review","volume":"25","author":"Marshall","year":"2025","journal-title":"BMC Health Serv 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