Food Insecurity Is Associated with Mild Cognitive Impairment among Middle-Aged and Older Adults in South Africa: Findings from a Nationally Representative Survey.

Ai Koyanagi,Davy Vancampfort,Sarah Jackson,Elvira Lara,Hans Oh,Lee Smith,Jae Shin,Nicola Veronese,Brendon Stubbs,Andrew Stickley

doi:10.3390/nu11040749

Abstract

There are no studies on the association between food insecurity and mild cognitive impairment (MCI). Thus, cross-sectional, community-based data on individuals aged ≥50 years from the World Health Organization’s Study on Global AGEing and Adult Health (SAGE) conducted in South Africa (2007–2008) were analyzed to assess this association. The definition of MCI was based on the National Institute on Ageing-Alzheimer’s Association criteria. Past 12-month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Multivariable logistic regression analysis was conducted. The sample consisted of 3,672 individuals aged ≥50 years [mean (SD) age 61.4 (18.3); 56% females]. The prevalence of MCI was 8.5%, while 11.0% and 20.8% experienced moderate and severe food insecurity, respectively. After adjustment for potential confounders, moderate and severe food insecurity were associated with 2.82 (95%CI = 1.65–4.84) and 2.51 (95%CI = 1.63–3.87) times higher odds for MCI compared with no food insecurity, respectively. The OR for those aged ≥65 years with severe food insecurity was particularly high (OR = 3.87; 95%CI = 2.20–6.81). In conclusion, food insecurity was strongly associated with MCI among South African older adults. Future longitudinal research is required to assess whether addressing food insecurity may reduce risk of MCI and subsequent dementia.

Highlights

Dementia is a debilitating syndrome that results in the deterioration of memory, thinking, behavior, and the ability to conduct daily activities
In our study on community-dwelling adults aged ≥50 years in South Africa, we found a high prevalence of food insecurity (31.8%)
Our findings are in line with previous studies that have examined the association between food insecurity and cognitive function in the USA these studies were on general cognitive function and not mild cognitive impairment (MCI)

Summary

Introduction

Dementia is a debilitating syndrome that results in the deterioration of memory, thinking, behavior, and the ability to conduct daily activities. It is one of the main causes of disability and dependency among the older adult population globally [1]. The 2016 Global Burden of Disease (GBD) study showed that 28.8 million disability-adjusted life years (DALYs) are attributed to dementia, and that dementia is the fifth leading cause of death globally [2]. As a consequence of global aging, the total number of people with dementia is expected to triple from its current figure by 2050 and reach 152 million, with this increase being largely attributable to rising numbers in LMICs [3]. There is a crucial need to identify modifiable risk factors for the preclinical transitional stages of dementia such as mild cognitive impairment (MCI)

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