Muzi Na

Document Type

Article

Abstract

Background

Despite findings from cross-sectional studies, how food insecurity experience/Supplemental Nutrition Assistance Program (SNAP) status relates to cognitive decline over time has not been fully understood.

Objectives

We aimed to investigate the longitudinal associations between food insecurity/SNAP status and cognitive function in older adults (≥65 y).

Methods

Longitudinal data from the National Health and Aging Trends Study 2012–2020 were analyzed (n = 4578, median follow-up years = 5 y). Participants reported food insecurity experience (5-item) and were classified as food sufficient (FS, no affirmative answer) and food insufficient (FI, any affirmative answer). The SNAP status was defined as SNAP participants, SNAP eligible nonparticipants (≤" role="presentation" style="box-sizing: border-box; margin: 0px; padding: 0px; display: inline-block; line-height: normal; font-size: 14.4px; font-size-adjust: none; word-spacing: normal; overflow-wrap: normal; text-wrap-mode: nowrap; float: none; direction: ltr; max-width: none; max-height: none; min-width: 0px; min-height: 0px; border: 0px; position: relative;">≤200% Federal Poverty Line, FPL), and SNAP ineligible nonparticipants (>200% FPL). Cognitive function was measured via validated tests in 3 domains, and the standardized domain-specific and combined cognitive function z-scores were calculated. Mixed-effect models with a random intercept were used to study how FI or SNAP status was associated with combined and domain-specific cognitive z-scores over time, adjusting for static and time-varying covariates.

Results

At baseline, 96.3% of the participants were FS and 3.7% were FI. In a subsample (n = 2832), 10.8% were SNAP participants, 30.7% were SNAP eligible nonparticipants, and 58.6% were SNAP ineligible nonparticipants. Compared with the FS group in the adjusted model (FI vs. FS), FI was associated with faster decline in the combined cognitive function scores [−0.043 (−0.055, −0.032) vs. −0.033 (−0.035, −0.031) z-scores per year, P-interaction = 0.064]. Cognitive decline rates (z-scores per year) in the combined score were similar in SNAP participants (β = −0.030; 95% CI: −0.038, −0.022) and SNAP ineligible nonparticipants (β = −0.028; 95% CI: −0.032, −0.024), both of which were slower than the rate in SNAP eligible nonparticipants (β = −0.043; 95% CI: −0.048, −0.038; P-interaction < 0.0001).

Conclusions

Food sufficiency and SNAP participation may be protective factors preventing accelerated cognitive decline in older adults.

Digital Object Identifier (DOI)

https://doi.org/10.1016/j.tjnut.2022.12.012

Rights

© 2023 The Authors. Published by Elsevier Inc. on behalf of American Society for Nutrition. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

APA Citation

Na, M., Dou, N., Brown, M. J., Chen-Edinboro, L. P., Anderson, L. R., & Wennberg, A. (2023). Food Insufficiency, Supplemental Nutrition Assistance Program (SNAP) Status, and 9-Year Trajectory of Cognitive Function in Older Adults: The Longitudinal National Health and Aging Trends Study, 2012–2020. The Journal of Nutrition, 153(1), 312–321. https://doi.org/10.1016/j.tjnut.2022.12.012

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