Aging
Food insecurity patterns in early adulthood to midlife and cognition: a sequence analysis approach Lucia Pacca* Lucia Pacca Pacca Pacca Pacca University of California San Francisco
Dementia is the 6th leading cause of death in the U.S., with marked disparities by socioeconomic status. Prior cross-sectional studies have found that food insecurity predicts lower cognition, but little research has evaluated lifecourse food insecurity. This study evaluates the association between food insecurity trajectories in emerging to middle adulthood, indicated by SNAP eligibility, and cognition.
Using a sample of 8,021 participants from the National Longitudinal Survey of Youth 1979, we determined SNAP eligibility status (yes/no) annually from age 22-45, according to 2008 USDA criteria based on income and assets. We calculated the similarity between SNAP eligibility trajectories using sequence analysis and grouped similar trajectories using cluster analysis. We then examined the association of SNAP eligibility clusters with overall cognition (z-score) around age 48, using linear regressions adjusted for individual-level socio-demographic characteristics.
We identified 10 clusters based on the timing and duration of SNAP eligibility. We found one cluster of persistently ineligible, two clusters of briefly eligible, two of intermittent eligibility, three of mostly persistent eligibility and two with long spells of eligibility (Figure 1). Compared to “persistently ineligible”, all clusters except for “brief, emerging adulthood eligibility” were associated with lower cognition. The association was stronger for individuals with longer periods of SNAP eligibility (e.g., “long spells of eligibility from age 25-35”: b=-0.53, 95% CI= -0.63, -0.43) than for those with intermittent eligibility (e.g., “intermittent middle adulthood eligibility”: b= -0.17, 95% CI: -.26, -.088).
Results suggest that food insecurity between in young and middle adulthood predicts lower cognitive functioning, especially when persistent. Given limited treatment options for dementia, targeting modifiable risk factors, such as expanding anti-hunger federal programs, may improve cognitive health.
