Hamadan University of Medical Sciences Journal of Education and Community Health 2820-896X 13 1 2026 03 31 Health Literacy and Health-Related Lifestyle Behaviors Among Older Adults: A Multivariable Analysis 39 50 10.34172/jech.4951 EN Issara Siramaneerat https://orcid.org/0000-0002-5332-7977 Warisara Sukumolchan https://orcid.org/0009-0003-1398-1784 Chalit Chaowilai Rutshaporn Chaitoopthong Journal Article 10.34172/jech.4951 2025 10 07 2026 03 07 Introduction: Health literacy (HL) is increasingly recognized as an important determinant of healthy aging because it influences individuals’ ability to access, understand, evaluate, and apply health information. However, evidence regarding the relationship between HL and health-related lifestyle behaviors (HLBs) among older adults in Thailand remains limited. This study aimed to examine HL and HLBs among older adults and identify socio-demographic and health-related factors associated with both outcomes. Methods: A cross-sectional study was conducted among 440 elderly individuals aged≥60 years in Pathum Thani, Thailand, recruited from community centers and primary healthcare facilities. Data were collected using structured questionnaires assessing socio-demographic characteristics, HL, health perception, and HLBs. Descriptive statistics, independent t-tests, one-way ANOVA, Pearson’s correlation analysis, and ordinary least squares regression were used for data analysis. Results: The overall mean health literacy score and the mean HLB score were 2.60 (SD=0.56) and 43.49 (SD=22.22), respectively. HL significantly differed based on marital status, education level, occupation, family income, income sufficiency, healthcare rights, and living arrangement (P<0.05). HL was positively correlated with health perception of illness (r=0.284, P<0.001) and HLB (r=0.141, P=0.003). In the regression model, education (β=0.226, P<0.001), family income (β=0.071, P<0.001), income sufficiency (β=0.182, P<0.001), marital status (β=0.118, P=0.001), and health perception of illness (β=0.134, P<0.001) were significant HL predictors. In the model predicting HLB, HL (β=0.169, P=0.005), health perception of illness (β=0.111, P<0.001), family income (β=0.085, P=0.006), income sufficiency (β=0.213, P=0.021), and marital status (β=0.195, P=0.004) were significantly associated with healthier lifestyle behaviors. Conclusion: HL was linked with HLBs among older adults and remained an essential predictor after adjustment for socio-demographic and health-related factors. Educational attainment, socioeconomic conditions, and health perception were related to HL and lifestyle behaviors. Interventions aimed at strengthening HL may support healthier lifestyles, thereby contributing to healthy aging among older adults.