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

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.