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(OR26-03-26) Trends in Food Insecurity and Cognitive Impairment Prevalence Among US Middle-Aged and Older Adults

Tuesday, July 28, 2026
8:54 AM - 9:06 AM ET
Location: Maryland Ballroom C
Emerging Leaders in Nutrition Science Poster Competition

    Presenting Author(s)

  • Heejin Lee, PhD

    Postdoctoral Research Fellow
    Harvard T.H. Chan School of Public Health
    Boston, Massachusetts, United States

    Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • EL

    Elizabeth Ludwig-Borycz

    Center for Global Health Equity, University of Michigan, United States

  • SH

    Steven Heeringa

    Institute for Social Research, University of Michigan, United States

  • Cindy W. Leung, ScD, MPH (she/her/hers)

    Associate Professor of Public Health Nutrition
    Harvard T.H. Chan School of Public Health
    Boston, Massachusetts, United States

Disclosure(s):
Heejin Lee, PhD: No relevant financial relationship(s) with ineligible companies to disclose.
Objectives: Food insecurity (FI) is a social determinant of health that may be associated with cognitive function in older adults. However, population-level trends in cognitive impairment across FI groups have not been well characterized. In this study, we examined national trends in the prevalence of Cognitive Impairment with No Dementia (CIND) by FI status among US adults aged >50 years old from the 2000-2021 Health and Retirement Study (HRS).

Methods: Data were drawn from the biennial HRS surveys from 2000–2001 through 2020–2021 (n=33,224, person-wave=178,677). FI was assessed using two items from the USDA Household Food Security Survey Module. The validated Langa-Weir classification was used to assess CIND. Weighted logistic regression models examined trends in CIND prevalence across survey years after adjusting for socioeconomic factors. Analyses were further stratified by sex, race and ethnicity, and educational attainment to examine trends across FI groups within these subgroups.

Results: Overall, the predicted prevalence of CIND decreased from 17.0% (95% CI 15.9-18.1) in 2000-2001 to 15.9% (95% CI 15.1-16.7) in 2020-2021 (P-trend=0.04). Trends in CIND prevalence differed marginally by FI status (P-interaction=0.07). Across all survey years, CIND prevalence was lowest among food-secure adults, declining from 16.4% (95% CI 15.3–17.5) in 2000–2001 to 14.6% (95% CI 13.8–15.4) in 2020–2021 (P-trend = 0.004). However, no significant trends were observed among adults with low food security (2000-2001, 24.0% [95% CI 21.6–26.5] – 2020-2021, 19.2% [95% CI 16.8–21.8]; P-trend = 0.22) or very low food security (2000-2001, 24.5% [95% CI 21.3–28.0] – 2020-2021, 27.8% [95% CI 24.3–31.5]; P-trend = 0.36). There were no significant differences in these trends by sex, race and ethnicity, or educational attainment.

Conclusions: The prevalence of CIND decreased from 2000 to 2021 overall, but this decreasing trend was observed only among food-secure adults. Further research is needed to understand persistently higher levels of CIND among adults with low or very low food security. Policies to improving food security may have important implications for reducing disparities in cognitive health.

Funding Sources: This work was supported by the National Institutes of Health (grant number R01AG0792786, PI: Leung).