Department of Sociology and Aging Studies Institute, Maxwell School of Citizenship and Public Affairs, Syracuse University, NY, United States.
Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, United States.
J Nutr. 2024 Jan;154(1):233-242. doi: 10.1016/j.tjnut.2023.11.015. Epub 2023 Nov 19.
Cognitive impairment and dementia are severe public health issues in aging populations, which can be exacerbated by insufficient or unhealthy dietary intake. Food (in)security status is linked to cognitive function among older adults, but the relationship is complex and can vary by sociodemographic characteristics.
This article aimed to investigate the association between food insecurity and cognitive function among United States older adults and explore potential variations by race and ethnicity groups.
We prospectively examined changes in cognitive function and incidence of cognitive impairment alongside the presence of self-reported food insecurity among older adults of different racial and ethnic groups. Data were from the 2012-2018 Health and Retirement Study (HRS) and the 2013 Health Care and Nutrition Study (HCNS), including N = 6,638 United States adults aged 50 years and older. Food insecurity was measured by a self-reported United States Household Food Security Survey Module, and cognitive function was assessed by the modified version of the Telephone Interview for Cognitive Status.
Results showed that 17% of United States older adults reported food insecurity in the 2013 HCNS. Compared with food secure older adults, those reporting food insecurity experienced worsened cognitive functioning over time (B = -0.63, p < .001), and they were more likely to have onset of cognitive impairment (OR= 1.46, p < .001) in the 6-y observation. Compared with non-Hispanic White older adults, being non-Hispanic Black, non-Hispanic Other, or Hispanic was associated with 2.96, 2.09, or 1.26 odds (p < .001) of cognitive impairment (2012-2018), respectively. Older adults of racial and ethnic minority groups also had higher risks of experiencing the double burden of cognitive impairment alongside food insecurity compared with non-Hispanic White older adults.
Findings underscore racial and ethnic structural disparities in food security and cognitive health in the United States aging population.
认知障碍和痴呆是老龄化人口中的严重公共卫生问题，而饮食摄入不足或不健康会加剧这些问题。食物（不安全）状况与老年人的认知功能有关，但这种关系很复杂，并且因社会人口特征而异。
本文旨在研究美国老年人中食物不安全与认知功能之间的关系，并探讨不同种族和族裔群体之间潜在的差异。
我们前瞻性地检查了不同种族和族裔群体的老年人中，自我报告的食物不安全与认知功能变化和认知障碍发生率之间的关系。数据来自 2012-2018 年健康与退休研究（HRS）和 2013 年医疗保健和营养研究（HCNS），共包括 6638 名年龄在 50 岁及以上的美国成年人。食物不安全通过自我报告的美国家庭粮食安全调查模块进行测量，认知功能通过修改后的电话访谈认知状态进行评估。
结果显示，在 2013 年 HCNS 中，17%的美国老年人报告存在食物不安全。与食物安全的老年人相比，报告食物不安全的老年人随着时间的推移认知功能下降（B = -0.63，p <.001），并且在 6 年的观察期间更有可能出现认知障碍（OR= 1.46，p <.001）。与非西班牙裔白人老年人相比，非西班牙裔黑人、非西班牙裔其他人或西班牙裔老年人发生认知障碍的几率分别为 2.96、2.09 或 1.26（p <.001）。与非西班牙裔白人老年人相比，种族和族裔少数群体的老年人也更有可能同时面临认知障碍和食物不安全的双重负担。
研究结果强调了美国老龄化人口中食物安全和认知健康方面的种族和族裔结构性差异。
