Food insecurity and cognitive function in older adults: Brief report

Objective: We evaluated the specific association between food insecurity and cognitive function among a national sample of the broader U.S. older adult population. Methods: Data from the 1999-2002 National Health and Nutrition Examination Survey (NHANES) were used to identify 1851 adults, between 60 and 85 years, with complete data on selected study variables. The Food Security Survey Module (FSSM) was administered to assess food insecurity. We used the 10 item U.S. Food Security Survey Module. Based on responses to the FSSM, four mutually exclusive categories were determined: fully food secure (0), marginally food secure (1-2), food insecure without hunger (3-5) and food insecure with hunger (6-10). The DSST (Digit Symbol Substitution Test) was used to assess cognitive functioning. Results: Compared to those who were fully food secure, those who were marginally food secure (beta = -13.4; 95% CI: -17.6, -9.2; P < 0.001), food insecure without hunger (beta = -10.9; 95% CI: -17.6, -4.1; P = 0.003) and food insecure with hunger (beta = 22.2; 95% CI: 28.6, 15.8; P < 0.001) had significantly lower cognitive function. After adjustments, results were attenuated, but remained statistically significant. Older adults who were marginally food secure (beta(adjusted) = -7.7; 95% CI: -11.9, -3.5; P = 0.001), food insecure without hunger (beta(adjusted) = 7.0; 95% CI: 11.4, 2.6; P = 0.003) and food insecure with hunger (beta(adjusted) = -14.4; 95% CI: -23.9, -4.5; P = 0.005) had significantly lower cognitive function. Conclusion: In this national sample of older adults, there was an inverse association between food insecurity and cognitive function. (C) 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.