(P22-037-25) Food Insecurity and Cognitive Domains Among Older US Adults: Findings From the Health and Retirement Study

Objectives: Cases of Alzheimer's disease and related dementias (ADRD) are expected to triple in the US in the next three decades. Food insecurity may be a risk factor for cognitive decline. In this study, we evaluated associations between household food insecurity and multiple cognitive domains (CDs) using a nationally representative sample of US older adults to address some of the prevailing gaps in the literature. We hypothesized that food insecurity is associated with worse performance in all CDs: memory, executive functioning, language, visuospatial functioning, and orientation.

Methods: Data came from 1,451 participants from the nationally representative Health and Retirement Study. Food insecurity was assessed in 2013, and cognition was assessed using the Harmonized Cognitive Assessment Protocol in 2016. All statistical analyses accounted for the HRS's complex study design. We used propensity score-based weighting, treating 2016 HCAP as the reference sample. We standardized the sum of all tests in the five CDs to a mean of 50 and a standard deviation of 10. Means and SE were presented for each CD separately by the food security status. To examine the associations between food security status and each CD (memory, executive function, language, visuospatial, and orientation) we used multivariate linear regression models. The first model adjusted for age and sex; the second model additionally adjusted for race/ethnicity, net worth, education, and marital status.

Results: The prevalence of food insecurity was 11.1%, average age was 69.5 years (SE=0.3), 54.5% were female, and 83.2% identified as non-Hispanic White. After adjusting for all covariates, food insecurity was inversely associated with executive functioning (β= -1.7, 95% CI -2.6, -0.7) but not significantly associated with memory, language, visuospatial functioning, or orientation.

Conclusions: In this nationally representative study of older adults, we found that food insecurity was associated with worse executive function but was not associated with function in other CDs. Collectively, this growing body of research is critically important to inform programs and policies that alleviate food insecurity, and that may improve cognitive health among older adults through improved food security.

Funding Sources: This study was supported by Grant Number R01AG079286 from the National Institute on Aging.