Food insecurity and subjective cognitive complaints among adults aged ≥ 65 years from low- and middle-income countries

Lee Smith; Guillermo F López Sánchez; Jae Il Shin; Karel Kostev; Benjamin R Underwood; Hans Oh; Pinar Soysal; Nicola Veronese; Felipe Schuch; Mark A Tully; Ai Koyanagi

doi:10.1007/s00394-023-03226-5

Food insecurity and subjective cognitive complaints among adults aged ≥ 65 years from low- and middle-income countries

Lee Smith, Guillermo F López Sánchez, Jae Il Shin, Karel Kostev, Benjamin R Underwood, Hans Oh, Pinar Soysal, Nicola Veronese, Felipe Schuch, Mark A Tully, Ai Koyanagi

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Abstract

PURPOSE: To date, no study has investigated the association between food insecurity and subjective cognitive complaints (SCC). Thus, the aims of the present study were to examine this association among older adults in low- and middle-income countries (LMICs), and to identify the potential mediators in this association, given the importance of SCC in dementia risk among older people, and the projected particularly large increase in dementia in this setting.

METHODS: Cross-sectional, community-based, nationally representative data from the World Health Organization (WHO) Study on global AGEing and Adult Health (SAGE) collected between 2007 and 2010 were analyzed. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 (No SCC) to 100 (worse SCC). Past 12 month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Multivariable linear regression and mediation (Karlson-Holm-Breen method) analyses were conducted to assess associations.

RESULTS: Data on 14,585 individuals aged ≥ 65 years [mean (SD) age 72.6 (11.5) years; 55.0% females] were analyzed. Severe food insecurity (vs. no food insecurity) was associated with 9.16 (95% CI = 6.95-11.37) points higher mean SCC score. Sleep/energy (mediated% 37.9%; P < 0.001), perceived stress (37.2%; P = 0.001), and depression (13.7%; P = 0.008) partially explained the association between severe food insecurity and SCC.

CONCLUSION: Food insecurity was associated with SCC among older adults in LMICs. Future studies should assess whether addressing food insecurity among older adults in LMICs can improve cognitive health.

Original language	English
Pages (from-to)	3217-3226
Number of pages	10
Journal	European Journal of Nutrition
Volume	62
Issue number	8
Early online date	7 Aug 2023
DOIs	https://doi.org/10.1007/s00394-023-03226-5
Publication status	Published online - 7 Aug 2023

Bibliographical note

Funding Information:
This paper uses data from WHO’s Study on Global Ageing and Adult Health (SAGE). SAGE is supported by the U.S. National Institute on Aging through Interagency Agreements OGHA 04034785, YA1323–08-CN-0020, Y1-AG-1005–01 and through research grants R01-AG034479 and R21-AG034263.

Funding Information:
Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. Dr. Guillermo F. López Sánchez is funded by the European Union–Next Generation EU. BUs post is part funded by a donation from Gnodde Goldman-Sachs Giving.

Publisher Copyright:
© 2023, The Author(s).

Keywords

Food insecurity
Low- and middle-income countries
Older adults
Subjective cognitive complaints

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s00394-023-03226-5

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Cite this

Smith, L., López Sánchez, G. F., Shin, J. I., Kostev, K., Underwood, B. R., Oh, H., Soysal, P., Veronese, N., Schuch, F., Tully, M. A., & Koyanagi, A. (2023). Food insecurity and subjective cognitive complaints among adults aged ≥ 65 years from low- and middle-income countries. European Journal of Nutrition, 62(8), 3217-3226. Advance online publication. https://doi.org/10.1007/s00394-023-03226-5

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abstract = "PURPOSE: To date, no study has investigated the association between food insecurity and subjective cognitive complaints (SCC). Thus, the aims of the present study were to examine this association among older adults in low- and middle-income countries (LMICs), and to identify the potential mediators in this association, given the importance of SCC in dementia risk among older people, and the projected particularly large increase in dementia in this setting.METHODS: Cross-sectional, community-based, nationally representative data from the World Health Organization (WHO) Study on global AGEing and Adult Health (SAGE) collected between 2007 and 2010 were analyzed. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 (No SCC) to 100 (worse SCC). Past 12 month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Multivariable linear regression and mediation (Karlson-Holm-Breen method) analyses were conducted to assess associations.RESULTS: Data on 14,585 individuals aged ≥ 65 years [mean (SD) age 72.6 (11.5) years; 55.0% females] were analyzed. Severe food insecurity (vs. no food insecurity) was associated with 9.16 (95% CI = 6.95-11.37) points higher mean SCC score. Sleep/energy (mediated% 37.9%; P < 0.001), perceived stress (37.2%; P = 0.001), and depression (13.7%; P = 0.008) partially explained the association between severe food insecurity and SCC.CONCLUSION: Food insecurity was associated with SCC among older adults in LMICs. Future studies should assess whether addressing food insecurity among older adults in LMICs can improve cognitive health.",

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author = "Lee Smith and {L{\'o}pez S{\'a}nchez}, {Guillermo F} and Shin, {Jae Il} and Karel Kostev and Underwood, {Benjamin R} and Hans Oh and Pinar Soysal and Nicola Veronese and Felipe Schuch and Tully, {Mark A} and Ai Koyanagi",

note = "Funding Information: This paper uses data from WHO{\textquoteright}s Study on Global Ageing and Adult Health (SAGE). SAGE is supported by the U.S. National Institute on Aging through Interagency Agreements OGHA 04034785, YA1323–08-CN-0020, Y1-AG-1005–01 and through research grants R01-AG034479 and R21-AG034263. Funding Information: Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. Dr. Guillermo F. L{\'o}pez S{\'a}nchez is funded by the European Union–Next Generation EU. BUs post is part funded by a donation from Gnodde Goldman-Sachs Giving. Publisher Copyright: {\textcopyright} 2023, The Author(s).",

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Smith, L, López Sánchez, GF, Shin, JI, Kostev, K, Underwood, BR, Oh, H, Soysal, P, Veronese, N, Schuch, F, Tully, MA & Koyanagi, A 2023, 'Food insecurity and subjective cognitive complaints among adults aged ≥ 65 years from low- and middle-income countries', European Journal of Nutrition, vol. 62, no. 8, pp. 3217-3226. https://doi.org/10.1007/s00394-023-03226-5

TY - JOUR

T1 - Food insecurity and subjective cognitive complaints among adults aged ≥ 65 years from low- and middle-income countries

AU - Smith, Lee

AU - López Sánchez, Guillermo F

AU - Shin, Jae Il

AU - Kostev, Karel

AU - Underwood, Benjamin R

AU - Oh, Hans

AU - Soysal, Pinar

AU - Veronese, Nicola

AU - Schuch, Felipe

AU - Tully, Mark A

AU - Koyanagi, Ai

N1 - Funding Information: This paper uses data from WHO’s Study on Global Ageing and Adult Health (SAGE). SAGE is supported by the U.S. National Institute on Aging through Interagency Agreements OGHA 04034785, YA1323–08-CN-0020, Y1-AG-1005–01 and through research grants R01-AG034479 and R21-AG034263. Funding Information: Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. Dr. Guillermo F. López Sánchez is funded by the European Union–Next Generation EU. BUs post is part funded by a donation from Gnodde Goldman-Sachs Giving. Publisher Copyright: © 2023, The Author(s).

PY - 2023/8/7

Y1 - 2023/8/7

N2 - PURPOSE: To date, no study has investigated the association between food insecurity and subjective cognitive complaints (SCC). Thus, the aims of the present study were to examine this association among older adults in low- and middle-income countries (LMICs), and to identify the potential mediators in this association, given the importance of SCC in dementia risk among older people, and the projected particularly large increase in dementia in this setting.METHODS: Cross-sectional, community-based, nationally representative data from the World Health Organization (WHO) Study on global AGEing and Adult Health (SAGE) collected between 2007 and 2010 were analyzed. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 (No SCC) to 100 (worse SCC). Past 12 month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Multivariable linear regression and mediation (Karlson-Holm-Breen method) analyses were conducted to assess associations.RESULTS: Data on 14,585 individuals aged ≥ 65 years [mean (SD) age 72.6 (11.5) years; 55.0% females] were analyzed. Severe food insecurity (vs. no food insecurity) was associated with 9.16 (95% CI = 6.95-11.37) points higher mean SCC score. Sleep/energy (mediated% 37.9%; P < 0.001), perceived stress (37.2%; P = 0.001), and depression (13.7%; P = 0.008) partially explained the association between severe food insecurity and SCC.CONCLUSION: Food insecurity was associated with SCC among older adults in LMICs. Future studies should assess whether addressing food insecurity among older adults in LMICs can improve cognitive health.

AB - PURPOSE: To date, no study has investigated the association between food insecurity and subjective cognitive complaints (SCC). Thus, the aims of the present study were to examine this association among older adults in low- and middle-income countries (LMICs), and to identify the potential mediators in this association, given the importance of SCC in dementia risk among older people, and the projected particularly large increase in dementia in this setting.METHODS: Cross-sectional, community-based, nationally representative data from the World Health Organization (WHO) Study on global AGEing and Adult Health (SAGE) collected between 2007 and 2010 were analyzed. Two questions on subjective memory and learning complaints in the past 30 days were used to create a SCC scale ranging from 0 (No SCC) to 100 (worse SCC). Past 12 month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Multivariable linear regression and mediation (Karlson-Holm-Breen method) analyses were conducted to assess associations.RESULTS: Data on 14,585 individuals aged ≥ 65 years [mean (SD) age 72.6 (11.5) years; 55.0% females] were analyzed. Severe food insecurity (vs. no food insecurity) was associated with 9.16 (95% CI = 6.95-11.37) points higher mean SCC score. Sleep/energy (mediated% 37.9%; P < 0.001), perceived stress (37.2%; P = 0.001), and depression (13.7%; P = 0.008) partially explained the association between severe food insecurity and SCC.CONCLUSION: Food insecurity was associated with SCC among older adults in LMICs. Future studies should assess whether addressing food insecurity among older adults in LMICs can improve cognitive health.

KW - Food insecurity

KW - Low- and middle-income countries

KW - Older adults

KW - Subjective cognitive complaints

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DO - 10.1007/s00394-023-03226-5

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VL - 62

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