Aging
Cumulative Supplemental Nutrition Assistance Program Participation and Memory Aging among US Older Adults, 1996-2018 Xuexin Yu* Xuexin Yu Katrina L Kezios Peiyi Lu Samuel L Swift Adina Zeki Al Hazzouri
Introduction: Supplemental Nutrition Assistance Program (SNAP) has been shown to effectively reduce food insecurity and improve health outcomes among low-income populations. Limited research has assessed the health effects of cumulative SNAP participation in later life, even though fluctuations or churn episodes in SNAP participation are common. We aimed to investigate the association between cumulative SNAP participation and subsequent memory function and decline among US older adults.
Methods: This prospective cohort study used data from US Health and Retirement Study 1996-2018. We included 2,633 adults aged 65 and over who were eligible for SNAP in at least one survey year between 1996-2004 (Cohort A) or 1998-2006 (Cohort B). We calculated the percentage of the time individuals participated in SNAP relative to the number of times they were eligible to participate over the 8-year period. We operationalized cumulative SNAP participation as never, intermittent (less than two-thirds of the time), and sustained (two-thirds or more of the time). We used composite memory z-scores that incorporated direct and proxy memory assessments as the outcome measure. We fit a mixed-effects linear regression model to investigate the association between SNAP participation and subsequent memory function and decline.
Results: Mean (SD) age at baseline was 74 (5.95), and 66.4% were women. A total of 2,257 (85.7%) participants never used SNAP, 219 (8.4%) participated in SNAP less than two-thirds of their eligible period, and 157 (6.0%) participated in SNAP two thirds or more of their eligible period. Compared to those who never participated in SNAP, individuals with intermittent (0.017 SD units; 95% CI: -0.002 to 0.036) and sustained SNAP participation (0.020 SD units; 95% CI: 0.001 to 0.040) experienced a slower rate of memory decline. The observed effect size was equivalent to delaying memory decline by 1.87 and 2.24 years per decade for SNAP intermittent and sustained participants.
Conclusions: Cumulative SNAP participation may help to preserve memory health among low-income older adults in the United States. Policy interventions are warranted to promote continuous SNAP enrollment among eligible individuals.
