Food insecurity associated with dementia risk

Key takeaways:

• Older adults with very low food security had slightly faster memory decline vs. those with low food security.
• Improving Supplemental Nutrition Assistance Program access may help reduce dementia disparities.

Food insecurity was linked to an increased risk for dementia and faster memory decline among older adults, according to a study published in JAMA Network Open.

Previous studies have shown that food insecurity negatively affects health and increases health care expenditures; however, many primary care physicians do not regularly screen for it.

“Food insecurity may lead to poor nutrition, trigger stress pathways, or increase the likelihood of poor cardiometabolic health and mental illness,” Haobing Qian, PhD, a social epidemiologist in the department of family and community medicine at the University of California, San Francisco, and colleagues wrote. “Ultimately, these factors, including food insecurity, may increase the risk of cognitive decline.”

The researchers evaluated 7,012 adults aged 50 years and older from the U.S. Health and Retirement Study (HRS) who had food insecurity data from 2013 and cognitive outcome data from 2014 to 2018. The participants had a mean age of 67 years, 58% were women and 69.2% were non-Hispanic white.

Compared with food-secure adults, Qian and colleagues found that those with low food security (OR = 1.38; 95% CI, 1.15-1.67) or very low food security (OR = 1.37; 95% CI, 1.11-1.59) were more likely to develop dementia.

Food insecurity also resulted in worse memory levels and faster rates of cognitive decline. Compared with food-secure adults, those with low and very low food security had about 0.7 and 1 year of excess cognitive aging per year, respectively.

“Memory decline diverged slightly faster among the very low food security group than the low food security group,” the researchers wrote.

Qian and colleagues noted that 11% of HRS participants aged 65 years and older reported food insecurity, which is about 4% higher than that reported in the 2020 U.S. Current Population Survey.

Additionally, those with food insecurity were typically younger and had lower educational attainment than those with food security.

“These findings suggest that food insecurity is more common among the same socioeconomically disadvantaged groups who are at high risk of dementia,” the researchers wrote. “Together, these findings highlight the role that social determinants of health may play later in life.”

Qian and colleagues concluded that efforts to improve the Supplemental Nutrition Assistance Program, like simplifying the application process for those with cognitive impairment, could help “reduce [Alzheimer's Disease and Alzheimer's Disease-Related Dementias] disparities and improve brain health.”