The Longitudinal and Dynamic Effects of Food Insecurity on Cognitive Impairment and Dementia Risk

Inequality, Life Course

Project Summary

By 2030, 8.5 million Americans will be diagnosed with Alzheimer’s disease and related dementias (ADRD); yet because socioeconomically disadvantaged populations are underrepresented in ADRD research, the extent of ADRD disparities by socioeconomic factors are poorly understood. Food insecurity, a condition of limited food availability due to insufficient resources, is an understudied dimension of socioeconomic disadvantage among older adults. Food insecurity has increased 128% among older adults since 2001, and has been associated with lower cognitive function in limited cross-sectional studies.

The lack of rigorous research investigating the effect of food insecurity on cognitive impairment and ADRD risk is a widely acknowledged gap in the health disparities and ADRD literature. This represents a major missed opportunity to better understand how a key social determinant of health can be influence cognitive health in later life.

The overall objective for this research is to understand the longitudinal and dynamic effects of food insecurity on cognitive impairment and ADRD risk in older adults. Food insecurity is both preventable and reversible; therefore, the rationale for this project is that establishing food insecurity as a risk factor for cognitive impairment and ADRD risk will inform public health strategies to address the dual burden of food insecurity and ADRD among older adults.

Our specific aims are: 1) evaluate the dynamic effects of food insecurity in adulthood on ADRD risk; 2) identify the longitudinal effects of food insecurity on trajectories of cognitive impairment; and 3) examine heterogeneity by sociodemographic characteristics and diet quality on the effects of food insecurity on cognitive impairment and ADRD risk. To achieve the proposed aims, this project will leverage data from two well-established cohort studies: 1) the Panel Study of Income Dynamics (PSID), the longest running nationally representative household panel survey, and 2) the Health and Retirement Study (HRS), the leading nationally representative study on aging.

This project will be the first to rigorously examine the effects of food insecurity on ADRD risk among older adults. By leveraging data from two longitudinal and nationally representative studies, this project will provide a complementary and comprehensive understanding of the effects of food insecurity on cognitive impairment and ADRD risk. These results will have significant clinical, public health, and policy implications by identifying modifiable risk factors to promote healthy cognitive aging and improve quality of life, particularly among socioeconomically disadvantaged populations.


Esther M Friedman, Lindsay H Ryan, Kenneth M Langa, Steven G Heeringa, Noura Elise Insolera

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