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Open AccessArticle

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

Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, 08830 Barcelona, Spain
Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, 28029 Madrid, Spain
ICREA, Pg. Lluis Companys 23, 08010 Barcelona, Spain
Aging Branch, Neuroscience Institute, National Research Council, 35128 Padova, Italy
National Institute of Gastroenterology “S. De Bellis” Research Hospital, Castellana Grotte, 70013 Bari, Italy
Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK
Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London WC2R 2LS, UK
Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford CM1 1SQ, UK
Department of Rehabilitation Sciences, KU Leuven, 3001 Leuven, Belgium
University Psychiatric Center KU Leuven, KU Leuven, 3000 Leuven, Belgium
Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo 187-8553, Japan
The Stockholm Center for Health and Social Change (SCOHOST), Södertörn University, 141 89 Huddinge, Sweden
School of Social Work, University of Southern California, CA 90015, USA
Department of Pediatrics, Yonsei University College of Medicine, Yonsei-ro 50, Seodaemun-gu, C.P.O. Box 8044, Seoul 03722, Korea
Division of Pediatric Nephrology, Severance Children’s Hospital, Seoul 03722, Korea
Institute of Kidney Disease Research, Yonsei University College of Medicine, Seoul 03722, Korea
Department of Behavioural Science and Health, University College London, London WC1E 7HB, UK
The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge CB1 1PT, UK
Department of Psychiatry, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-Princesa), 28006 Madrid, Spain
Author to whom correspondence should be addressed.
Nutrients 2019, 11(4), 749;
Received: 27 February 2019 / Revised: 25 March 2019 / Accepted: 26 March 2019 / Published: 30 March 2019
(This article belongs to the Special Issue Ageing and Nutrition through Lifespan)
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. View Full-Text
Keywords: mild cognitive impairment; food insecurity; South Africa; epidemiology mild cognitive impairment; food insecurity; South Africa; epidemiology
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Koyanagi, A.; Veronese, N.; Stubbs, B.; Vancampfort, D.; Stickley, A.; Oh, H.; Shin, J.I.; Jackson, S.; Smith, L.; Lara, E. Food Insecurity Is Associated with Mild Cognitive Impairment among Middle-Aged and Older Adults in South Africa: Findings from a Nationally Representative Survey. Nutrients 2019, 11, 749.

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