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美国老年人的食物不安全与痴呆风险:来自 2013-2021 年收入动态面板研究的证据。

Food Insecurity and Dementia Risk in U.S. Older Adults: Evidence From the 2013-2021 Panel Study of Income Dynamics.

机构信息

Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.

Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.

出版信息

J Gerontol B Psychol Sci Soc Sci. 2024 Nov 1;79(11). doi: 10.1093/geronb/gbae153.

Abstract

OBJECTIVES

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 were from 3,232 adults (≥65 years) from the Panel Study of Income Dynamics. Food insecurity was assessed biennially using the U.S. Household Food Security Survey Module from 2015 to 2019. Probable dementia risk was assessed biennially using the Eight-Item Interview to Differentiate Aging and Dementia from 2017 to 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 2-fold higher association between food insecurity and probable dementia risk (odds ratio 2.11, 95% confidence interval: 1.12-3.98). The 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.

摘要

目的

越来越多的研究表明,食物不安全与认知功能下降有关;然而,需要前瞻性研究来检验食物不安全与痴呆风险之间的关系。本研究使用纵向和全国代表性数据,考察了食物不安全对老年人痴呆风险的影响。

方法

数据来自收入动态面板研究的 3232 名成年人(≥65 岁)。从 2015 年到 2019 年,使用美国家庭粮食安全调查模块每两年评估一次食物不安全情况。从 2017 年到 2021 年,使用八项目访谈来区分衰老和痴呆,每两年评估一次可能的痴呆风险。采用逆概率加权和边际结构模型来控制食物不安全以及社会人口学和健康混杂因素的时变性质。

结果

在考虑了基线和时变的社会人口学和健康混杂因素后,食物不安全与可能的痴呆风险之间存在两倍的关联(优势比 2.11,95%置信区间:1.12-3.98)。将暴露因素扩展到包括边缘性粮食不安全,将结果扩展到包括知情人报告的记忆丧失,结果仍然稳健。此外,食物不安全与可能的痴呆风险之间的关联在性别、种族和民族以及是否参与补充营养援助计划方面没有差异。

讨论

食物不安全是一个可改变的健康社会决定因素。需要采取干预措施和政策来减少食物不安全,促进老年人的健康老龄化。

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