Food insecurity late in life linked to increased dementia risk, research suggests

Research conducted by the University of Michigan, US, has found that food insecurity during midlife and later in life is linked to increased risk of developing dementia by a fourfold, compared to individuals who remain food secure. 

The researchers used longitudinal data from the Institute for Social Research Panel Study of Income Dynamics, which they say is the longest-running nationally representative household panel survey in the US. Using this data allowed the team to track food insecurity among the same families over decades and see the pattern of cognitive health associations 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 co-author of the study, Noura Insolera, assistant research scientist at the Institute for Social Research at the University of Michigan. 

“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.”

Although the families experiencing food insecurity were in the minority, the researchers emphasize the importance of “when it occurred.”Linking food insecurity and dementia

The study, published in The American Journal of Clinical Nutrition, included data from 2,051 adults, out of whom 3% experienced food insecurity only in midlife, 5.2% only later in life, and 5% during both of the periods. They measured midlife during 1999–2003 and later life between 2015–2019.

Although the families experiencing food insecurity were in the minority, the researchers emphasize the importance of “when it occurred.” They found that the strongest association with dementia was between being food insecure later in life, and no association was found between being food insecure during midlife.

These findings therefore suggest a link between cognitive health and food insecurity later in life, although the study cannot determine it to be the cause of dementia, as there may be other factors playing an important role.

“Food insecurity has different adverse impacts across the life course,” says Insolera. “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,” she argues.

Nutrition’s role in cognitive health

The researchers note that among those who experienced food insecurity in both midlife and later in life, they had a 40% probability of developing dementia, and those who experienced it in late life only had a 34% probability.

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

“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.”

Another study published last year found that older people who follow a healthy diet have a slower development of chronic diseases, including dementia. Such diets prioritize consuming vegetables, fruit, whole grains, nuts, legumes, and unsaturated fats, while reducing the intake of sweets, red and processed meat, and butter or margarine.

The research team also highlights that the findings question how food insecurity should be met by health care providers and policymakers.Food insecurity in health care

The research team highlights that the findings question how food insecurity should be met by health care providers and policymakers.

Insolera suggests: “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.” 

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

Advocating for a greater focus on nutrition in US healthcare, the Food Is Medicine Coalition and Harvard Law School released a “first-of-its-kind” national framework earlier this year, designed to inform hospital professionals how to introduce medically tailored meals into the US health care system.