Food Insecurity Is Associated with Lower Cognitive Functioning in a National Sample of Older Adults

Abstract

Background: Food insecurity, a social and economic condition of inadequate food resources, is known to affect cognitive development in children. However, research is sparse among adult populations, particularly older adults who may be more susceptible to accelerated cognitive decline. Objective: The aim of this study was to examine the associations between food insecurity and cognitive functioning among older adults. Methods: Data came from 1823 older adults (≥60 y) with incomes ≤300% of the federal poverty level (FPL) from the 2011-2014 NHANES. Food security was measured using the 10-item Adult Food Security Survey Module. Cognitive function was measured using the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) word learning subtest and delayed word recall, the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST). The cognitive assessments were then standardized and an overall cognitive function z score was created by averaging across all cognitive assessments. Associations with food insecurity were examined using multivariate linear regression models, adjusting for sociodemographic and health characteristics. Results: In the analytic population, the prevalence of food insecurity was 23.7%. Across all cognitive assessments, the mean scores among food-insecure adults was significantly lower than the mean scores among food-secure adults. After adjusting for sociodemographic and health characteristics, food insecurity was associated with lower scores on the CERAD word learning subtest (β =-0.14, 95% CI:-0.26,-0.01), the AFT (β =-0.13, 95% CI:-0.25,-0.002), and the DSST (β =-0.24, 95% CI:-0.33,-0.15). Food insecurity was also associated with a lower score on the overall cognitive function z score (β =-0.15, 95% CI:-0.26,-0.05). Conclusions: In this national sample of 1823 adults aged ≥60 y, food insecurity was inversely associated with cognitive function, which may translate into higher risk of cognitive impairment over time.