The Longitudinal and Dynamic Effects of Food Insecurity on Cognitive Impairment and Dementia Risk

项目摘要 到2030年，将有850万美国人被诊断患有阿尔茨海默病和相关痴呆症（ADRD）; 由于社会经济弱势群体在ADRD研究中的代表性不足， 社会经济因素造成的ADRD差异知之甚少。粮食不安全，粮食有限的状况 由于资源不足而无法获得，是社会经济不利因素的一个未得到充分研究的方面， 美国的健康问题。自2010年以来，老年人的粮食不安全状况增加了128%。 2001，并且在有限的横断面研究中与较低的认知功能相关。缺乏 调查食品不安全对认知障碍和ADRD风险的影响的严格研究是一项广泛的 在健康差异和ADRD文献中存在公认的差距，这是一个错失的主要机会， 更好地了解健康的一个关键社会决定因素如何影响晚年的认知老化。整体 这一应用的目的是了解粮食不安全的纵向和动态影响， 认知障碍和ADRD风险。核心假设是，粮食不安全增加了 通过不良饮食质量、心脏代谢健康状况， 心理困扰和心理健康状况不佳，所有这些都已被先前的研究所证实。食品 不安全是可以预防和逆转的;因此，该项目的理由是， 不安全感作为认知障碍和ADRD风险的风险因素将为公共卫生战略提供信息， 并防止老年人面临粮食不安全和ADRD的双重负担。为了实现拟议的目标， 该项目将利用两项成熟的队列研究的数据：1）收入动态的小组研究 （PSID），持续时间最长的全国代表性家庭小组调查，以及2）健康和 退休研究（HRS），领先的全国代表性老龄化研究。我们的具体目标是：1） 评估成年期食物不安全对ADRD风险的动态影响; 2）确定以下因素的纵向影响： 粮食不安全对认知障碍轨迹的影响;以及3）检查社会人口统计学的异质性 特征和饮食质量对食物不安全对认知障碍和ADRD风险的影响。通过 利用两项全国代表性研究的数据，该项目将是第一个提供 对粮食不安全对认知能力的长期影响 损伤和ADRD风险。这些结果将具有重要的临床，公共卫生和政策影响， 确定一个可改变的风险因素，以促进健康的认知老化和改善生活质量，特别是 社会经济弱势群体。

PROJECT SUMMARY By 2030, 8.5 million Americans will be diagnosed with Alzheimer’s disease and related dementias (ADRD); yet because socioeconomically disadvantaged populations are underrepresented in ADRD research, the extent of ADRD disparities by socioeconomic factors are poorly understood. Food insecurity, a condition of limited food availability due to insufficient resources, is an understudied dimension of socioeconomic disadvantage and a persistent health concern in the United States. Food insecurity has increased 128% among older adults since 2001, and has been associated with lower cognitive function in limited cross-sectional studies. The lack of rigorous research investigating the effect of food insecurity on cognitive impairment and ADRD risk is a widely acknowledged gap in the health disparities and ADRD literature, and represents a major missed opportunity to better understand how a key social determinant of health can influence cognitive aging in later life. The overall objective for this application is to understand the longitudinal and dynamic effects of food insecurity on cognitive impairment and ADRD risk. The central hypothesis is that food insecurity increases the risk of accelerated cognitive impairment and ADRD through poor diet quality, cardiometabolic health conditions, psychological distress, and poor mental health, all of which has been demonstrated by prior research. Food insecurity is both preventable and reversible; therefore, the rationale for this project is that establishing food insecurity as a risk factor for cognitive impairment and ADRD risk will inform public health strategies to address and prevent the dual burden of food insecurity and ADRD among older adults. To achieve the proposed aims, this project will leverage data from two well-established cohort studies: 1) the Panel Study of Income Dynamics (PSID), the longest running nationally representative household panel survey, and 2) the Health and Retirement Study (HRS), the leading nationally representative study on aging. Our specific aims are to: 1) evaluate the dynamic effects of food insecurity in adulthood on ADRD risk; 2) identify the longitudinal effects of food insecurity on trajectories of cognitive impairment; and 3) examine heterogeneity by sociodemographic characteristics and diet quality on the effects of food insecurity on cognitive impairment and ADRD risk. By leveraging data from two nationally representative studies, this project will be the first to provide a complementary and comprehensive understanding of the long-term effects of food insecurity on cognitive impairment and ADRD risk. These results will have significant clinical, public health, and policy implications by identifying a modifiable risk factor to promote healthy cognitive aging and improve quality of life, particularly among socioeconomically disadvantaged populations.