Health Anxiety and Health Behaviors by eHealth Literacy in Older Adults

Background: Older adults increasingly rely on online health information; however, limited eHealth literacy may amplify health anxiety and cyberchondria, thereby compromising engagement in positive health behaviors. Understanding whether eHealth literacy buffers these adverse psychological influences can inform targeted interventions for aging populations. Objective: To examine whether eHealth literacy moderates the association between health anxiety and health behaviors among older adults, and to identify demographic and psychological predictors of health behaviors. Methods: This was a cross-sectional correlational study reported in accordance with Strengthening the Reporting of Observational Studies in Epidemiology guidelines of a convenience sample of 400 community-dwelling adults aged ≥ 60 years. Data were collected via structured survey administration. Results: Higher eHealth literacy was associated with more favorable health behaviors and lower levels of cyberchondria and health anxiety. In regression models, education, online health information‑seeking frequency, eHealth literacy, cyberchondria, and health anxiety emerged as independent predictors of health behaviors. Moderation analyses indicated that eHealth literacy buffered the negative association between health anxiety and health behaviors. Discussion: eHealth literacy appears to function as a protective factor in later life by reducing the adverse association between health anxiety and engagement in positive health behaviors, while also relating inversely to cyberchondria. Although educational attainment remained a significant predictor, psychological variables accounted for substantial additional amount of variance in health behaviors. Integrating eHealth literacy training with anxiety-informed support in gerontological care may strengthen preventive and self-management behaviors among older adults in community and clinical settings.