The associations of SNAP use and memory function among us older adults: Findings from the health and retirement study

Abstract

AbstractBackgroundStudies on the health effect of Supplemental Nutrition Assistance Program (SNAP) on the cognitive health of older adults are scarce. In this study, we examined the associations of SNAP use and memory function trajectories among US older adults.MethodOur sample included 3,555 SNAP‐eligible participants (aged 50+) from the 1996 Health and Retirement Study survey, among whom 559 were SNAP users and 2,996 were non‐users. SNAP eligibility was constructed based on household income and assets compared to the federal criterion. Memory function was assessed biennially from 1996 through 2016. To account for pre‐existing differences in characteristics and variations in survey attrition between SNAP users and non‐users, we modeled the probability of SNAP use and of attrition using pre‐SNAP exposure (i.e., 1994) demographic and health covariates. We then modeled trajectories of memory function across SNAP use using linear mixed effect models weighted by the inverse probability of treatment (i.e. SNAP use) and of attrition. We also cross‐examined the results in a propensity score (PS) matched sample (N = 1,050).ResultSNAP users in 1996 had lower socioeconomic status and worse health at baseline than SNAP non‐users, and were more likely to be lost to follow‐up. Results using IP‐weights suggested SNAP users had worse memory scores at baseline but slower memory decline compared with non‐users (annual decline rate is ‐0.038 standard units [95%CI = ‐0.044, ‐0.033] for non‐users and ‐0.043 [95%CI = ‐0.046, ‐0.040] for users). Results from the PS‐matched sample also showed SNAP users had slower memory declines compared with non‐users (annual decline rate was ‐0.052 units [95%CI = ‐0.055, ‐0.050] for non‐users and ‐0.048 units [95%CI = ‐0.051, ‐0.046] for users).ConclusionAfter accounting for pre‐existing differences between eligible SNAP users and non‐users as well as differential loss to follow‐up, our findings suggested that SNAP participation is associated with slower memory decline among eligible older adults.