{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T11:51:44Z","timestamp":1772797904040,"version":"3.50.1"},"reference-count":50,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T00:00:00Z","timestamp":1745539200000},"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. Public Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The global increase in the older adults population which represents 22% the population in Portugal and is especially pronounced in the Alentejo region, posed noteworthy challenges. Social isolation, particularly in rural areas, requires policies that promote inclusion and wellbeing, such as social prescription. This study aimed to conduct a multidimensional assessment of the older adults individuals in Alentejo, evaluating quality of life, wellbeing, functionality, loneliness and health literacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cross-sectional design was performed involving 344 participants aged 65 and over, residing in the Alentejo region. Validated scales and Questionnaires were used to assess sociodemographic characteristics, quality of life, wellbeing, functionality, loneliness and health literacy. Data were analyzed using SPSS software, employing descriptive and inferential statistics to identify significant patterns and relationships between variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The sample consisted of 52% women, with an average age of 75.3\u202fyears (SD\u202f=\u202f7.31; range\u202f=\u202f65\u201396\u202fyears). Wellbeing, as measured by the WHO-5 index, was preserved with an average score of 53 (SD\u202f=\u202f4.29). Loneliness was prevalent, with 50% of participants experiencing it, and the average score on the UCLA Loneliness Scale was 41.9 (SD\u202f=\u202f5.59). Pain and anxiety were the most commonly reported issues according to the EQ-5D-3L, with 57.3% reporting pain\/discomfort and 48.5% reporting anxiety\/depression. Health literacy levels were low, with, only 6.4% exhibiting excellent literacy, while 45.0% had problematic or inadequate literacy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The findings suggest that while preserved, significant differences exist between men and women, as well as between rural and urban residents. Mobility, pain, and anxiety were the primary factors affecting Quality of life, particularly in rural areas. Low health literacy was identified as a barrier to autonomy and effective health management, emphasizing the need for tailored interventions to promote active and healthy aging.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1514968","type":"journal-article","created":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T04:10:59Z","timestamp":1745554259000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["A multidimensional analysis of older adults wellbeing and health literacy in Alentejo: a cross-sectional study"],"prefix":"10.3389","volume":"13","author":[{"given":"Rute","family":"Sadio","sequence":"first","affiliation":[]},{"given":"Adriana","family":"Henriques","sequence":"additional","affiliation":[]},{"given":"Paulo","family":"Nogueira","sequence":"additional","affiliation":[]},{"given":"Andreia","family":"Costa","sequence":"additional","affiliation":[]}],"member":"1965","published-online":{"date-parts":[[2025,4,25]]},"reference":[{"key":"ref1","year":"2019"},{"key":"ref2","year":"2021"},{"key":"ref3","first-page":"1","volume-title":"Resumo de pol\u00edticas da Unece sobre o envelhecimento n\u00ba 18.Idosos em \u00e1reas rurais e remotas","year":"2017"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1016\/j.socscimed.2018.04.051","article-title":"Linking green space to neighborhood social capital in older adults: the role of perceived safety","volume":"207","author":"Hong","year":"2018","journal-title":"Soc Sci Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1218091","DOI":"10.3389\/fpubh.2023.1218091","article-title":"Green space and the health of the older adult during pandemics: a narrative review on the experience of COVID-19","volume":"11","author":"Tabrizi","year":"2023","journal-title":"Front Public Heal"},{"key":"ref6","year":"2016"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1093\/ije\/dyt215","article-title":"Hypertension among older adults in lowand middle-income countries: prevalence, awareness and control","volume":"43","author":"Lloyd-Sherlock","year":"2014","journal-title":"Int J Epidemiol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/healthcare10081568","article-title":"Family networks, social networks, and life satisfaction of older adults in China","volume":"10","author":"Cheng","year":"2022","journal-title":"Healthcare"},{"key":"ref9","first-page":"1","article-title":"Proje\u00e7\u00f5es de Popula\u00e7\u00e3o Residente 2080. Contudo, na \u00c1rea Metropolitana de Lisboa e no Algarve a popula\u00e7\u00e3o residente poder\u00e1 aumentar","year":"2020","journal-title":"Destaque informa\u00e7\u00e3o \u00e0 Comun Soc"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2018\/4086294","article-title":"The impact of quality of life on the health of older people from a multidimensional perspective","volume":"2018","author":"Garc\u00eda","year":"2018","journal-title":"J Aging Res"},{"key":"ref11","article-title":"Financial wellbeing in later life","year":"2014","journal-title":"Univ Bristol"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"4755146","DOI":"10.1155\/2024\/4755146","article-title":"The impact of positive self-perceptions of aging on subjective well-being through the mediation of psychological resilience among community-dwelling older adults during COVID-19 in Taiwan","volume":"2024","author":"Chen","year":"2024","journal-title":"Health Soc Care Commun"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"14362","DOI":"10.3390\/ijerph192114362","article-title":"The mental health impact of the COVID-19 pandemic on older adults in China: a systematic review","volume":"19","author":"Liu","year":"2022","journal-title":"Int J Env Res Public Heal"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2196\/26474","article-title":"Impact of the COVID-19 pandemic on older adults: rapid review","volume":"4","author":"Lebrasseur","year":"2021","journal-title":"JMIR Aging"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"717692","DOI":"10.3389\/fmed.2021.717692","article-title":"COVID-19 isolation and risk of death in Cyprus elderly people","volume":"8","author":"Kyriazis","year":"2021","journal-title":"Front Med"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/hsr2.320","article-title":"Effects of social prescribing pilot project for the elderly in rural area of South Korea during COVID-19 pandemic","volume":"4","author":"Kim","year":"2021","journal-title":"Heal Sci Rep"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1177\/1745691614568352","article-title":"Loneliness and social isolation as risk factors for mortality: a meta-analytic review","volume":"10","author":"Holt-lunstad","year":"2015","journal-title":"Perspect Psychol Sci"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1186\/s12889-020-8251-6","article-title":"Loneliness and social isolation interventions for older adults: a scoping review of reviews","volume":"20","author":"Fakoya","year":"2020","journal-title":"BMC Public Health"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"4172","DOI":"10.3390\/ijerph20054172","article-title":"Health literacy among older adults in Portugal and associated sociodemographic, health and healthcare-related factors","volume":"20","author":"Costa","year":"2023","journal-title":"Int J Environ Res Public Health"},{"key":"ref20","first-page":"1","article-title":"Exploring the influencing factors of health literacy among older adults: a cross-sectional survey","volume":"56","author":"Chiu","year":"2020","journal-title":"J Med"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"4","DOI":"10.3389\/fpubh.2023.1323335","article-title":"Current status and influencing factors of health literacy among older adults in combined medical and nursing care institutions: a cross-sectional study","volume":"11","author":"Tao","year":"2024","journal-title":"Front Med"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"2333721416630492","DOI":"10.1177\/2333721416630492","article-title":"Health literacy and older adults: a systematic review","volume":"2","author":"Chesser","year":"2016","journal-title":"Gerontol Geriatr Med"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1016\/j.ypmed.2013.11.012","article-title":"Limited health literacy is a barrier to colorectal cancer screening in England: evidence from the English longitudinal study of ageing","volume":"61","author":"Kobayashi","year":"2014","journal-title":"Prev Med"},{"key":"ref24","volume-title":"Digital literacy among Korean older adults. Digit Health: a scoping review of quantitative studies","author":"Kang","year":"2023"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"5","DOI":"10.24310\/innoeduca.2023.v9i1.16433","article-title":"Barriers to digital inclusion among older people: a intergenerational reflection on the need to develop digital competences for the group with the highest level of digital exclusion","volume":"9","author":"Tomczyk","year":"2023","journal-title":"Innoeduca Int J Technol Educ Innov"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1113864","DOI":"10.3389\/fpubh.2023.1113864","article-title":"Loneliness and social networks of older adults in rural communities: a narrative synthesis systematic review","volume":"11","author":"Hussain","year":"2023","journal-title":"Front Public Health"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"e30842","DOI":"10.1016\/j.heliyon.2024.e30842","article-title":"Rural-urban differences in older adults\u2019 life satisfaction and its determining factors","volume":"10","author":"Rey-Beiro","year":"2024","journal-title":"Heliyon"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"106620","DOI":"10.1016\/j.ypmed.2021.106620","article-title":"Effectiveness of a community-wide intervention for population-level frailty and functional health in older adults: a 2-year cluster nonrandomized controlled trial","volume":"149","author":"Seino","year":"2021","journal-title":"Prev Med"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1590\/0102-37722015011637087096","article-title":"Qualidade De Vida, Morbilidade Psicol\u00f3gica e stress familiar em Idosos Residentes na Comunidade quality of life, psychological morbidity and family stress in elderly residing in the community","volume":"31","author":"Roncon","year":"2015","journal-title":"Psicol Teor e Pesqui"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"39","DOI":"10.37914\/riis.v2i2.57","article-title":"Fatores de Isolamento Social do Idoso em Meio Rural","volume":"2","author":"Lorenzo","year":"2019","journal-title":"Rev Investig Inova\u00e7\u00e3o em Sa\u00fade"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1089\/tmj.2012.0308","article-title":"Telemedicine in Alentejo","volume":"20","author":"Oliveira","year":"2014","journal-title":"Telemed e-Health"},{"key":"ref32","article-title":"Basic epidemiology","author":"Bonita","year":"2006","journal-title":"World Heal Organ"},{"key":"ref33","volume-title":"Fundamentos e etapas do processo de Investiga\u00e7\u00e3o","author":"Fortin","year":"2009"},{"key":"ref34","year":"1998"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"664","DOI":"10.20344\/amp.1317","article-title":"Contribution for the validation of the Portuguese version of EQ-5D contributos Para a Valida\u00e7\u00e3o da Vers\u00e3o Portuguesa do EQ-5D","volume":"26","author":"Ferreira","year":"2013","journal-title":"Acta Med Port"},{"key":"ref36","first-page":"59","article-title":"Valida\u00e7\u00e3o do \u00cdndice de Barthel numa amostra de idosos n\u00e3o institucionalizados","volume":"25","author":"Ara\u00fajo","year":"2007","journal-title":"Rev Port Sa\u00fade P\u00fablica"},{"key":"ref37","first-page":"217","volume-title":"Valida\u00e7\u00e3o da escala de Lawton e Brody numa amostra de idosos n\u00e3o institucionalizados. Actas do 7","author":"Ara\u00fajo","year":"2007"},{"key":"ref38","first-page":"65","article-title":"Valida\u00e7\u00e3o Psicom\u00e9trica da Escala UCLA-Loneliness para Idosos Portugueses","volume":"18","author":"Pocinho","year":"2010","journal-title":"Intera\u00e7\u00f5es Soc e novas Mod"},{"key":"ref39","first-page":"2","article-title":"The HLS 19-Q12 instrument to measure general health literacy development of the instrument","year":"2022","journal-title":"Action Netw Meas Popul Organ Heal Lit"},{"key":"ref40","first-page":"40","article-title":"A influ\u00eancia do g\u00eanero nos dom\u00ednios da qualidade de vida em idosos de uma unidade de sa\u00fade de V it\u00f3ria-ES The influence of gender on quality of life in elderly people at a health unit in V it\u00f3ria-ES","volume":"1","author":"Oliveira","year":"2023","journal-title":"Clin Biopsychosoc"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"1043420","DOI":"10.3389\/fpsyg.2022.1043420","article-title":"Gender differences in the subjective well-being of older adult learners in China","volume":"13","author":"Shi","year":"2022","journal-title":"Front Psychol"},{"key":"ref42","first-page":"75","article-title":"Satisfa\u00e7\u00e3o e Qualidade de Vida em idosos portugueses","volume-title":"Envelhecer em Portugual Psicologia, sa\u00fade e presta\u00e7\u00e3o de cuidados","author":"Pa\u00fal","year":"2005"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"107922","DOI":"10.1016\/j.buildenv.2021.107922","article-title":"Ten questions concerning age-friendly cities and communities and the built environment","volume":"199","author":"van Hoof","year":"2021","journal-title":"Build Environ"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"e0182920","DOI":"10.1371\/journal.pone.0182920","article-title":"The association between observed mobility and quality of life in the near elderly","volume":"12","author":"Shafrin","year":"2017","journal-title":"PLoS One"},{"key":"ref45","first-page":"2131","volume-title":"Perspectives on aging and quality of life","author":"Noto","year":"2023"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"723925","DOI":"10.3389\/fpubh.2021.723925","article-title":"Examining rural and racial disparities in the relationship between loneliness and social technology use among older adults","volume":"9","author":"Byrne","year":"2021","journal-title":"Front Public Health"},{"key":"ref47","doi-asserted-by":"publisher","first-page":"204","DOI":"10.12968\/bjcn.2021.26.4.204","article-title":"Social prescribing in the community","volume":"26","author":"Mendes","year":"2021","journal-title":"Br J Community Nurs"},{"key":"ref48","first-page":"104606","article-title":"Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and mandarin on the novel coronavirus COVID-19","volume":"99","author":"Colucci","year":"2020","journal-title":"The COVID-19 resource centre is hosted on Elsevier Connect, the company\u2019 s public news and information"},{"key":"ref49","doi-asserted-by":"publisher","first-page":"515469","DOI":"10.3389\/fpubh.2020.515469","article-title":"Social prescribing\u2014an effort to apply a common knowledge: impelling forces and challenges","volume":"8","author":"Islam","year":"2020","journal-title":"Front Public Heal"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1089\/pop.2017.0109","article-title":"Need for comprehensive health care quality measures for older adults","volume":"21","author":"MacLeod","year":"2018","journal-title":"Popul Health Manag"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1514968\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T04:11:03Z","timestamp":1745554263000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1514968\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,25]]},"references-count":50,"alternative-id":["10.3389\/fpubh.2025.1514968"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1514968","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,25]]},"article-number":"1514968"}}