The Cognitive and Behavioral Impact of Health Misinformation on Older Adults

Abstract

This study examines how exposure to health misinformation is associated with risk appraisal, emotional responses, and self-reported behavioral change among older adults in Shanghai. Guided by the stimulus–organism–response (S–O–R) model and the risk perception attitude (RPA) framework, the study tests a cognitive–affective pathway in which misinformation exposure (stimulus) shapes perceived risk and negative affect (organism), which in turn relate to behavioral change (response). Data were collected through an online cross-sectional survey of adults aged 60 years and older residing in Shanghai (N = 750). Results indicate that misinformation exposure is positively associated with higher perceived risk. Higher perceived risk is linked to stronger negative affect, which leads to increased behavioral change. Negative affect partially mediates the association between perceived risk and behavioral change, while perceived risk also shows a direct association with behavioral change. Contrary to expectations, fact-checking neither moderates the exposure-risk association nor shows a significant direct association with perceived risk. Overall, the findings support a risk appraisal–emotional response pathway through which misinformation exposure may translate into behavioral adjustment in everyday information environments. The results suggest that interventions aimed at older adults may need to go beyond encouraging fact-checking and instead support risk calibration, strengthen credibility assessment, and address affective responses triggered by misinformation exposure.