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    Home»Neurology»Where Food Security Makes a Difference: Older Adults Who Use F… : Neurology Today
    Neurology

    Where Food Security Makes a Difference: Older Adults Who Use F… : Neurology Today

    brainwealthy_vws1exBy brainwealthy_vws1exDecember 15, 2022No Comments9 Mins Read
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    Article summary

    Older adults who availed of food benefits under the Federal Nutrition Assistance Program experienced about two years less cognitive aging over a 10-year period than those who did not avail of eligible SNAP benefits, according to a National Institute of Health study. Data review. An aging-sponsored health and retirement study was discovered.

    Eligible older adults who took advantage of food benefits under the Federal Supplemental Nutrition Assistance Program (SNAP) outperformed older adults who were eligible but did not use SNAP, according to a new study by researchers at the Columbia University Mailman School of Public Health. Cognitive decline was slower than yoke.

    Adina Zeki Al-Hazzoli, Ph.D., assistant professor of epidemiology at the Robert N. Butler Columbia Center for Aging, and colleagues in 1996 in a National Institute on Aging-sponsored health and retirement study of people over the age of 50. We reviewed data on 3,555 SNAP-eligible participants.

    A total of 15.7% of study participants were SNAP users, of lower socioeconomic background and with more chronic diseases than non-users. They also had worse baseline memory scores than non-SNAP users.

    However, when memory function was assessed every two years from 1996 to 2016 using a composite score, SNAP users had a slower rate of memory decline than their non-SNAP counterparts ( -0.038 vs -0.046), the researchers wrote in November. 9 Online version neurology.

    “In other words, our findings suggest that SNAP users experience approximately two years less cognitive aging per decade compared to non-users,” the authors wrote.

    Researchers said previous studies found that SNAP benefits were associated with “increased food security and improved physical and mental health” in children, but the results in adults were largely mixed. He pointed out that there is

    The researchers also speculated about some “underlying mechanisms” behind the link between SNAP and brain health and cognition.

    “By consuming a higher quality diet and improving nutritional intake, SNAP may benefit brain health by reducing oxidative stress and neuroinflammation, which in turn promotes neuronal integrity. “SNAP may also increase purchasing power and investment in other health maintenance behaviors, leading to lower health care costs as well as better access to care. .”

    “SNAP may also reduce the stress and overall financial hardship associated with premature cognitive aging and declining brain health,” Dr. Al Hazzouri added.

    The role of food insecurity

    “I think this is a very important study,” said Charles Windon, M.D., Ph.D., assistant professor of clinical neurology at the Center for Memory and Aging at the University of California, San Francisco, who was not involved in the study.

    Figure 1

    “Food insecurity screening can give clinicians at least some sense of the risks that patients may be facing and the potential adverse health consequences.”—DR. Colleen Heflin

    “We haven’t discussed the issue of food insecurity among older people enough.”[in discussions of] “No Kid Hungry” program. However, this has become a major problem among older people and has been exacerbated by the pandemic. In the community work I do and among my patients in the clinic, I often see food-insecure elderly people with cognitive disabilities. ”

    The study has limitations, he acknowledged. We evaluated the use of SNAP at only one time point and were able to identify Association between SNAP use and slowing of cognitive decline, rather than causative factors.

    “We were also very interested in including biomarkers such as hippocampal and cortical volumes in our analysis, but we may not have been able to do this based on the authors’ data sources,” said Dr. Windon. rice field.

    “However, the authors did a very good job of addressing confounders, using propensity scores to determine whether individuals who use SNAP differ from SNAP-eligible individuals who do not use it.” We’ve fixed the problem.”

    Also, in conjunction with the large body of scientific literature showing links between good nutrition and cognitive performance in older adults, this study suggests that increased access to food security to higher quality foods may contribute to It has been suggested that it may have benefits for brain health.

    “Better food security will enable better management of chronic health conditions that older people may have, such as diabetes, which can lead to cognitive impairment, and chronic blood sugar problems due to malnutrition. It’s possible,” said Dr Windon.

    “Also, well-nourished older adults may be more likely to participate in health-promoting activities because they are less concerned about food insecurity, enjoy stable blood sugar levels, and generally Because it makes me feel better.”

    Colleen Heflin, Ph.D., associate dean, chair, and professor of public management and international affairs at the Maxwell School of Civil Rights and Public Affairs at Syracuse University, said the paper “reveals how important nutritional support is to health outcomes. It helps to make ”

    The program’s fifth iteration, the federal Healthy People 2030 initiative, identifies public health priorities to improve health and well-being across the country and sets goals to deliver those improvements over the next decade. To do. He also recognizes that food security is a social determinant of health, Dr. Heflin said.

    “To us Universal While it’s important to understand how important it is, this highlights key aspects that are critical to people’s ability to live independently,” Dr. Heflin said. “There are clear biological mechanisms by which this association makes sense, which is consistent with some of my own research looking at the other side of the coin.”

    Food insecurity is known to be a significant problem among older Americans. In 2020, her more than 9 million Americans in households with people over the age of 50 were food insecure, but most seniors do not participate in her SNAP program.

    According to Dr. Heflin’s research, this may be partly due to barriers due to cognitive decline.

    “There are a lot of logistical challenges involved in participating in SNAP,” she observed. “You have to show up with all the proper documents within a specified time frame. There is a possibility.”

    A study published in August 2022 found that gerontology journalDr. Heflin and colleagues also found, based on data from the Health and Retirement Study, that lower levels of cognitive function leading to the classification of dementia are strongly associated with lower rates of SNAP use, especially among eligible older adults. I found For women and those who live alone.

    “In summary, this [Neurology] Research and ours suggest that there is a strong relationship between SNAP and cognition in older adults, perhaps going both ways,” she said. This can help prevent or mitigate cognitive decline, but cognitive decline makes it difficult to have the resources needed to ensure food security.”

    What can a neurologist do?

    What can neurologists do to identify patients at risk for food insecurity and help those with cognitive impairment receive the food benefits they need?

    A two-item screening measure known as hunger vital signs has been validated to identify food insecurity in households. It is often touted as a tool for assessing food insecurity in families with children and is specifically endorsed by the American Academy of Pediatrics, but is also used in many common clinical settings. The Department of Veterans Affairs offers it at all medical centers.

    “This can be used to identify adults of all ages who are experiencing food insecurity,” Dr. Heflin said. “Food insecurity screening can give clinicians at least some sense of the risks that patients may be facing and the potential adverse health consequences.”

    Hunger vital signs contain two statements: I didn’t have the money to get more than that. ”

    A family or individual is at risk of food insecurity if they say either or both statements are ‘often true’ or ‘sometimes true’ (rather than ‘never true’). be identified.

    “This information will help guide the conversation with the patient about a comprehensive action plan that addresses all of the contributing factors to cognitive impairment,” says Dr. Windon.

    “It made me think about the social determinants of health, and potentially do something about it. Many of us are excited about new treatments for dementia that may soon become available, If we can prevent significant cognitive decline through interventions such as improved nutrition, it will be more cost-effective in the long run and lead to more life impact.”

    Given that there are certain barriers identified by studies such as Dr. Heflin’s, once you find a patient with cognitive impairment taking SNAP, you should check in regularly to make sure the patient is still taking SNAP. Making sure you can access the benefits is beneficial, said Eric Rimm. PhD, Professor of Epidemiology and Nutrition, Director of the Cardiovascular Epidemiology Program at the Harvard TH Chang School of Public Health, and Professor of Medicine at the Harvard He Medical School.

    “What you don’t want is for someone’s cognitive impairment to interfere with their ability to stay on SNAP,” said Dr. Rimm.

    He notes that in addition to SNAP, several states, including Massachusetts and California, include reimbursement within Medicare and Medicaid for food insecurity screening, counseling, and referral to a range of “food is medicine” programs. You said you are running a pilot program.

    “This could become a routine, reimbursable part of routine clinical screening, much like cholesterol and blood pressure,” he said.

    If you don’t have such a program in your state, there are many other resources that neurology practices should be aware of for patients with food insecurity, Dr. Heflin said.

    “In most areas, [the phone number] 211 provides connectivity to social services, including emergency food aid. That’s how you find help quickly,” she said. “We can also develop relationships with local community-supported offices on aging, senior centers, and other congregational and home delivery meal providers.”

    Dr. Windon said the new findings will have implications for further longitudinal studies.

    “The role of SNAP has been investigated more in terms of how it affects children as they grow into adulthood.” It would be interesting to see that the risk of developing cognitive impairment or neurodegenerative disease does not begin at age 50 or 60, but much earlier in life, with individuals from socioeconomically disadvantaged backgrounds Children who receive these interventions early in life not only do better in school, but also because good nutrition impacts development early on. Is there a lower risk of cognitive impairment as we age?”



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