Food insecurity and dementia risk in US older adults: Evidence from the 2013-2021 Panel Study of Income Dynamics

Cindy W Leung; Noura E Insolera; Julia A Wolfson; Claire T McEvoy; Lindsay H Ryan; Esther M Friedman; Kenneth M Langa; Steven G Heeringa; Wei Hao

doi:10.1093/geronb/gbae153

Food insecurity and dementia risk in US older adults: Evidence from the 2013-2021 Panel Study of Income Dynamics

J Gerontol B Psychol Sci Soc Sci. 2024 Sep 7:gbae153. doi: 10.1093/geronb/gbae153. Online ahead of print.

Authors

Cindy W Leung¹, Noura E Insolera², Julia A Wolfson³, Claire T McEvoy⁴, Lindsay H Ryan², Esther M Friedman², Kenneth M Langa⁵, Steven G Heeringa², Wei Hao⁶

Affiliations

¹ Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
² Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.
³ Department of International Health and Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
⁴ Centre for Public Health, Institute of Clinical Sciences, Queen's University Belfast, Northern Ireland, United Kingdom.
⁵ Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA.
⁶ Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.

PMID: 39243138
DOI: 10.1093/geronb/gbae153

Abstract

Objective: Growing research suggests that food insecurity is associated with worse cognitive functioning; however, prospective studies are needed to examine food insecurity and dementia risk. Using longitudinal and nationally representative data, we examined the effects of food insecurity on dementia risk among older adults.

Methods: Data came from 3,232 adults (≥65 years) from the Panel Study of Income Dynamics. Food insecurity was assessed biennially using the US Household Food Security Survey Module from 2015-2019. Probable dementia risk was assessed biennially using the Eight Item Interview to Differentiate Aging and Dementia (AD8) from 2017-2021. Inverse probability weighting and marginal structural models were used to account for the time-varying nature of food insecurity and sociodemographic and health confounders.

Results: After accounting for baseline and time-varying sociodemographic and health covariates, there was a two-fold higher association between food insecurity and probable dementia risk (OR 2.11, 95% CI 1.12, 3.98). Results were robust to expanding the exposure to include marginal food security, and the outcome to include informant-reported memory loss. Furthermore, there was no evidence of heterogeneity in the association of food insecurity and probable dementia risk by sex, race and ethnicity, or participation in the Supplemental Nutrition Assistance program.

Discussion: Food insecurity is a modifiable social determinant of health. Interventions and policies are needed to reduce food insecurity and promote healthy aging for older adults.

Keywords: Cohort analysis; Dementia; Economic status; Health disparities; Nutrition.

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