The relationship between health literacy and active and successful aging: a cross-sectional study of active aging service center

Abstract Background While successful aging focuses on physical health and disease prevention, active aging offers a broader framework encompassing social participation and security. Health literacy is considered a vital tool in achieving these outcomes, yet its specific impact on the synergy between both aging paradigms requires further exploration. Objective This study aims to evaluate the relationship between health literacy, successful ageing, and active ageing among older adults and to identify the factors associated with active ageing levels. Method This descriptive and cross-sectional study was conducted between October 2024 and May 2025 at the Metropolitan Municipality’s Active Aging Service Center in Antalya, Türkiye. The study included 306 participants aged 65 and over. Data were collected using a Demographic Information Form, the Active Ageing Scale, the Successful Ageing Scale, and the Turkish Health Literacy Scale. Data analysis included descriptive statistics, independent samples t-test, Chi-square, Pearson correlation, and Multiple Linear Regression. Results The study involved 306 older adults with an average age of 67.79 ± 3.56 years (79.4% of participants were women, and 70.6% were university graduates). Whilst the majority of participants reported having a chronic illness (66.0%) and taking medication regularly (64.7%), 58.5% engaged in regular physical exercise and 80.7% engaged in regular mental activities. The mean total score for the Active Ageing Scale was 190.10 ± 39.37, for the Successful Ageing Scale it was 57.74 ± 7.61, and for the Health Literacy Index it was 32.97 ± 9.53. Bivariate analyses revealed that higher levels of education, income, regular physical exercise and mental activity were significantly associated with better health literacy and ageing outcomes ( p < 0.05). Furthermore, positive correlations were found between active ageing, successful ageing and health literacy ( p < 0.01). Multiple linear regression analysis showed that the model statistically significantly predicted active aging and explained 56.4% of the total variance (R² = 0.564, p < 0.05). While age, mental activity, and health literacy emerged as significant predictors, education and regular exercise were found to be insignificant. Conclusion Health literacy is a key factor of active and successful ageing. To promote active ageing, older adults care centres should prioritise health literacy.