Food Insufficiency, Supplemental Nutrition Assistance Program (SNAP) Status, and 9-Year Trajectory of Cognitive Function in Older Adults: The Longitudinal National Health and Aging Trends Study, 2012–2020

Associations of Food Insecurity and Memory Function Among Middle to Older–Aged Adults in the Health and Retirement Study

“…Covariates of interest included time-invariant baseline confounders measured in 1998 and time-varying confounders that were recorded at each wave and time-updated between 1998 and 2016. Based on earlier literature, 10 , 11 , 12 , 16 , 17 , 18 , 19 , 36 , 37 , 38 , 39 these confounders were hypothesized to affect both food insecurity status and cognitive function and decline; we used a directed acyclic graph to specify our assumptions regarding the associations between confounders, food insecurity exposure, and memory over time ( Figure 1 ). As shown in the directed acyclic graph, we posited the existence of exposure-confounder feedback whereby the time-varying confounders are both influenced by exposure to food insecurity at one time point and affect food insecurity status at a later time point.…”

“… 3 Among middle to older–aged adults, research on food insecurity and health is relatively scarce, 4 although earlier evidence has shown food insecurity to be associated with various physical and mental health outcomes, 4 , 5 , 6 , 7 , 8 , 9 including cognition. 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 As population aging accelerates, understanding the association between food insecurity and brain health among older adults is a national public health priority. 20 …”

“…To date, most research on food insecurity and cognition in middle to older–age adults has examined this association using cross-sectional data and has suggested that food insecurity is associated with poorer global cognition and lower performance on assessments of executive function and memory 10 , 11 , 12 ; by comparison, very few studies in adults have examined this association longitudinally. 16 , 17 , 18 , 19 For example, a longitudinal study of Puerto Rican adults aged 49 to 75 years living in Boston, Massachusetts, reported that food insecurity was associated with a significantly faster 2-year decrease in global cognition and executive function, and a smaller and nonsignificant decrease in memory function. 17 More recently, in a cohort of US adults older than 65 years with 9 years of follow-up, food insufficiency at baseline was associated with a faster annual decrease in global cognition and immediate and delayed recall, but not executive function.…”

“… 17 More recently, in a cohort of US adults older than 65 years with 9 years of follow-up, food insufficiency at baseline was associated with a faster annual decrease in global cognition and immediate and delayed recall, but not executive function. 16 However, in these studies food insecurity was assessed just once at study baseline. In a study in which food insecurity was assessed at 3 different time points, researchers found that persistently food-insecure older residents in Miami, Florida, were at higher risk of cognitive impairment after 2 years of follow-up, although cognitive decline was not examined in this study.…”

Late-life food insecurity and cognition: exploring timing, duration, and mechanisms among older Mexican adults

“…Recent work has suggested that food insecurity may also negatively impact the brain and cognitive function [ 21 , 22 ]. Studies have reported effects of food insecurity on outcomes spanning lower cognitive function [ 23 – 29 ], faster cognitive decline [ 30 – 32 ], mild cognitive impairment [ 33 – 37 ], and dementia [ 38 , 39 ].…”