Food Insecurity in Later Life Tied to Higher Dementia Risk

The study in The American Journal of Clinical Nutrition found the strongest association among people experiencing food insecurity later in life. Researchers found no significant association between food insecurity in midlife alone and probable dementia.

Food insecurity is often discussed in terms of hunger and access to adequate nutrition, but researchers increasingly are examining its potential connections to health across the life course.

The study used longitudinal data from the University of Michigan’s Institute for Social Research Panel Study of Income Dynamics, the longest-running nationally representative household panel survey in the United States. The survey allowed researchers to track food insecurity within the same families over decades and examine whether the timing of food insecurity was associated with cognitive health in later years.

“Not only can we now track the changes one family experiences, but by collecting this information for decades, we can also examine different parts of the life course,” says Noura Insolera, assistant research scientist at ISR.

“We have known for some time that hunger and nutritional deficiencies make it harder for children to learn in school, for example, but only by collecting this information year after year for many years can we look at something like the connections between food insecurity and dementia risk.”

This study followed 2,051 adults and looked at whether they experienced food insecurity at two different periods: midlife (1999–2003) and later life (2015–2019). Of the total of the adults studied, 3% experienced food insecurity only in midlife, 5.2% experienced it only in later life and 5% experienced it during both periods.

While food-insecure families are in the minority, when it occurred mattered. The association with probable dementia was concentrated among those who experienced food insecurity in later life, rather than midlife alone.

The findings suggest that food insecurity in later adulthood may be particularly important to cognitive health. However, the study cannot determine whether food insecurity itself contributes to dementia or whether other factors associated with food insecurity help explain the relationship.

“Food insecurity has different adverse impacts across the life course,” Insolera says. “If you have been to the doctor recently, there are often screening questions for food security upon intake, but health practitioners are often at a loss when tasked with helping their patients. They are often not equipped, as medical doctors, to solve these problems. The first step is identifying the problem by asking questions, but the next step is much more complicated.”

The people who experienced food insecurity in both midlife and later have an estimated probability of dementia of 40% as compared with 11% of those who were food secure in both midlife and later life. Those who reported food insecurity in later-life only also saw a statistically significant increased probability of 34%.

“As individuals age, there are many factors, including financial safety, community, family and government programs that help to make sure needs are met,” Insolera says.

“If someone is forced to choose to pay a bill that may accrue interest if unpaid or spend less money on food, the food is often seen as the easier option to forgo.

“The physical toll that a lack of nutrition has on the body is a tangible health issue, but the mental strain of worry and anxiety about where their next meal might come from is also a very real problem. Food insecurity causes both of these, and the combination of these adverse physical and mental conditions can create a problem that is larger than the sum of its parts.”

The findings also raise questions about how health care providers and policymakers can respond to food insecurity, the researchers say.

“If there is one thing I could change, it would be to go back to the generosity of benefits that SNAP was able to provide during the pandemic,” Insolera says.

“The federal government was able to swiftly intervene and help American families in a very successful way. If those levels of benefit would have been kept, we might not see the increases in food insecurity we have seen since those benefits expired.”

Source: University of Michigan