Accelerated Cognitive Decline Observed in Older Adults with Food Insecurity


New research on Medicare beneficiary data suggests that older adults who face food insecurity concerns may be at greater risk of more rapid declines in cognitive health.

Boeun Kim, PhD, MPH


Boeun Kim, PhD, MPH


Older adults with reported food insecurity were shown to have greater risk of quicker declines in executive function, according to recent findings.1

Given that cognitive decline can negatively affect quality of life and the ability to function independently in later years, researchers have been focused on identifying factors that can be modified to prevent or delay it, such as food insecurity.2

There is limited research on the association between food insecurity and cognitive decline, so establishing a link between these factors was seen as a potential enhancement of understanding of the effectiveness of interventions and policies aimed at tackling food insecurity.

The study was authored by Boeun Kim, PhD, MPH, from Johns Hopkins University’s School of Nursing.

“Accordingly, we undertook a longitudinal analysis to examine the association between time-variant measures of food insecurity with changes in cognitive function among a nationally representative sample of US adults 65 years and older,” Kim and colleagues wrote.

Background and Findings

The investigators performed a retrospective cohort analysis using data collected from from the National Health and Aging Trends Study (NHATS), a representative sample of Medicare beneficiaries who were 65 years and up. They gathered and assessed data from 2012 to 2020, with a follow-up period of up to 7 years.

The team assessed the participants’ self-reported food insecurity from the period of 2012 to 2019 as the primary exposure, and they assessed immediate memory, delayed memory, and executive function as main outcomes and measures.

They measured the participants’ immediate and delayed recall through a 10-item word-list memory task, and they assessed executive function by a test in which participants drew a clock (higher scores would indicate a more accurate depiction). The investigators linked each year's cognitive function data to the previous year's food insecurity data.

Of the 3037 total participants assessed in their research, 1345 were under the age of 75, 56.2% of them were female, and 84.9% were White.

Overall, the investigators concluded that over the course of 7 years, 417 of the participants (about 12.1%) reported experiences with food insecurity at least once. The team further noted that food insecurity was shown to be linked to more rapid declines in executive function, with a mean annual difference of -0.04 (95% CI, -0.09 to -0.003) points between participants who experienced food insecurity and those who did not, after adjusting for other factors.

Notably, however, the investigators did not report a substantial association between food insecurity and changes in immediate or delayed memory, with differences of 0.01 (95% CI, -0.05 to 0.08) and -0.01 (95% CI, -0.08 to 0.06) points, respectively.

The team also added that the link between food insecurity and executive function is small, but they pointed out that a subtle decline may indicate preclinical dementia and continued cognitive decline in several different areas.

“The adverse effects of food insecurity on cognitive health call for interventions and policies incorporating a variety of approaches such as addressing food quality, food preferences, transportation, food preparation, and food purchase to eliminate food insecurity,” they wrote.


  1. Kim B, Samuel LJ, Thorpe RJ, Crews DC, Szanton SL. Food Insecurity and Cognitive Trajectories in Community-Dwelling Medicare Beneficiaries 65 Years and Older. JAMA Netw Open. 2023;6(3):e234674. doi:10.1001/jamanetworkopen.2023.4674.
  2. Na M, Dou N, Ji N, et al. Food insecurity and cognitive function in middle to older adulthood: a systematic review. Adv Nutr. 2020;11(3):667-676. doi:10.1093/advances/nmz122.
Related Videos
Primary Care Roles in Alzheimer Diagnosis, with Theresa Sivers-Teixeira, MSPA, PA-C
James R. Kilgore, DMSc, PhD, PA-C: Cognitive Decline Diagnostics
Etienne Sibille, PhD: Innovations in Cognitive Pathology
Alayne Markland, DO | Credit:
© 2024 MJH Life Sciences

All rights reserved.