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Stephan Y, Sutin AR, Luchetti M, Aschwanden D, Terracciano A. Personality and Transition From Mild Cognitive Impairment to Normal Cognition vs Dementia. J Am Med Dir Assoc 2024:105175. [PMID: 39074784 DOI: 10.1016/j.jamda.2024.105175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 06/20/2024] [Accepted: 06/24/2024] [Indexed: 07/31/2024]
Abstract
OBJECTIVES Mild cognitive impairment (MCI) is a critical stage preceding incident dementia, but not all individuals with MCI progress to dementia and some revert to normal cognition. This study examined whether personality is associated with the probability of transition from MCI to normal cognition or dementia. DESIGN Longitudinal observational study. SETTING AND PARTICIPANTS Older adults with MCI from the Health and Retirement Study (N = 1608, 56% female, mean age = 72.29, SD = 9.91). Personality traits; cognitive status; and demographic (age, sex, education, race, and ethnicity), clinical (diabetes, hypertension), behavioral (smoking, physical activity), psychological (depressive symptoms), and genetic (apolipoprotein E ε4) covariates were obtained in 2006/2008. Follow-up data on cognitive status were collected every 2 years up to the 2020 wave. METHODS Cox regression analyses tested the association between personality and reversion from MCI to normal cognition and progression to dementia, controlling for demographic, clinical, behavioral, psychological, and genetic covariates. RESULTS Controlling for demographic factors, lower neuroticism and higher openness and conscientiousness were associated with a higher likelihood of reversion from MCI to normal cognition and a lower risk of progression to dementia over time. Higher agreeableness was related to a lower risk of progression to dementia. Clinical, behavioral, psychological, and genetic factors partially accounted for these associations. There was little evidence that demographic, genetic factors, or baseline cognition moderated these associations. CONCLUSIONS AND IMPLICATIONS Personality traits can help identify individuals who are more likely to revert from MCI and not progress to dementia. These findings suggest that even during mild impairment, personality may modulate dementia risk and thus inform targeted interventions.
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Affiliation(s)
| | - Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA
| | - Martina Luchetti
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA
| | - Damaris Aschwanden
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland; Department of Geriatrics, College of Medicine, Florida State University, Tallahassee, FL, USA
| | - Antonio Terracciano
- Department of Geriatrics, College of Medicine, Florida State University, Tallahassee, FL, USA
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Scott JJ, Bruine de Bruin W, Rabinovich L, Frazzini A, de la Haye K. Understanding food insecurity in Los Angeles County during the COVID-19 pandemic and its aftermath: A qualitative interview study. Appetite 2024; 198:107323. [PMID: 38556057 DOI: 10.1016/j.appet.2024.107323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 03/19/2024] [Accepted: 03/23/2024] [Indexed: 04/02/2024]
Abstract
The COVID-19 pandemic brought increases in food insecurity in Los Angeles (L.A.) County, defined as lacking household access to adequate food because of limited money or other resources. Here, we aimed to understand the lived experiences of food insecurity during the COVID-19 pandemic and its aftermath. In August-December 2022, we interviewed 30 residents of L.A. County who were participants in an ongoing internet panel and had reported experiencing food insecurity between April 2020 and July 2021. A stratified-sampling approach was used to recruit a diverse sample with and without government food assistance. We report five key findings, which underscore the stress and worry associated with the experience of food insecurity, and the coping strategies people implemented: (1) The pandemic prompted food insecurity as well as stressful shifts in eating behaviors compared to before the pandemic, with some eating much less food, some eating less nutritious food, and some eating much more due to being stuck at home; (2) Buying food became more effortful and financially challenging; (3) Government food assistance from the Supplemental Nutrition Assistance Program (SNAP) was important for reducing food insecurity, but was sometimes insufficient, inconsistent, and didn't cover all retailers or food items; (4) Interviewees had to rely on their social networks, food banks or pantries, churches, and schools to meet their food needs and cope with food insecurity, but some faced barriers in doing so; (5) For some, food insecurity was worse in late 2022, almost two years after the pandemic started. We conclude with implications for policymakers and practitioners, emphasizing the importance of meeting the needs of diverse residents and addressing food insecurity in the aftermath of the COVID-19 pandemic.
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Affiliation(s)
- Jose J Scott
- Sol Price School of Public Policy, University of Southern California, USA; Center for Economic and Social Research, University of Southern California, USA.
| | - Wändi Bruine de Bruin
- Sol Price School of Public Policy, University of Southern California, USA; Dornsife Department of Psychology, University of Southern California, USA; Schaeffer Center for Health Policy and Economics, University of Southern California, USA; Center for Economic and Social Research, University of Southern California, USA.
| | - Lila Rabinovich
- Center for Economic and Social Research, University of Southern California, USA
| | - Alison Frazzini
- Los Angeles County Chief Sustainability Office, County of Los Angeles, USA
| | - Kayla de la Haye
- Center for Economic and Social Research, University of Southern California, USA
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Sutin AR, Luchetti M, Stephan Y, Terracciano A. Purpose in life and cognitive performance and informant ratings of cognitive decline, affect, and activities. J Int Neuropsychol Soc 2024; 30:244-252. [PMID: 37609873 PMCID: PMC10884354 DOI: 10.1017/s1355617723000516] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
OBJECTIVE To examine (1) the association between purpose in life and multiple domains of cognitive function and informant-rated cognitive decline, affect, and activities; (2) whether these associations are moderated by sociodemographic factors, cognitive impairment, or depression; (3) whether the associations are independent of other aspects of well-being and depressive symptoms. METHOD As part of the 2016 Harmonized Cognitive Assessment Protocol from the Health and Retirement Study, participants completed a battery of cognitive tests and nominated a knowledgeable informant to rate their cognitive decline, affect, and activities. Participants with information available on their purpose in life from the 2014/2016 Leave Behind Questionnaire were included in the analytic sample (N = 2,812). RESULTS Purpose in life was associated with better performance in every cognitive domain examined (episodic memory, speed-attention, visuospatial skills, language, numeric reasoning; median β =.10, p <.001; median d =.53). Purpose was likewise associated with informant-rated cognitive decline and informant-rated affective and activity profiles beneficial for cognitive health (median β =.18, p < .001; median d =.55). There was little evidence of moderation by sociodemographic or other factors (e.g., depression). Life satisfaction, optimism, positive affect, and mastery were generally associated with cognition. When tested simultaneously with each other and depressive symptoms, most dimensions were reduced to non-significance; purpose remained a significant predictor. CONCLUSIONS Purpose in life is associated with better performance across numerous domains of cognition and with emotional and behavioral patterns beneficial for cognitive health that are observable by knowledgeable others. These associations largely generalize across demographic and clinical groups and are independent of other aspects of well-being.
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Sutin AR, Luchetti M, Stephan Y, Sesker AA, Terracciano A. Purpose in life and stress: An individual-participant meta-analysis of 16 samples. J Affect Disord 2024; 345:378-385. [PMID: 38706462 PMCID: PMC11068359 DOI: 10.1016/j.jad.2023.10.149] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
Background Purpose in life is a psychological resource that has been associated with better regulation of stress. The present research reports a coordinated analysis of the association between purpose in life and subjective stress and evaluates potential sociodemographic and mental health moderators of this association. Methods With individual participant data from 16 samples (total N=108,391), linear regression examined the association between purpose in life and general subjective feelings of stress, controlling for sociodemographic characteristics. Results Greater purpose in life was associated with less subjective stress (meta-analytic estimate=-.228, 95% Confidence Interval=-.292, -.164; p<.001). Interaction terms between sociodemographic factors and purpose tested in the individual samples and synthesized with meta-analysis were not significant, which indicated that the association between purpose and stress was similar across age, sex, race, ethnicity, and education. The association was also not moderated by psychological distress. Meta-regressions further indicated that this association was generally similar across scale length, content of the purpose measure, and across samples from Eastern and Western countries. Limitations The associations reported are observational. Experimental work is needed to evaluate causality. Conclusions Purpose in life is associated with less subjective stress across populations. Less subjective stress may be one mechanism through which purpose contributes to better mental and physical health.
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Affiliation(s)
| | | | | | - Amanda A. Sesker
- Florida State University College of Medicine
- University of Minnesota Medical School–Duluth
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Nicklett EJ, Cheng GJ, Morris ZA. Predictors of food insecurity among older adults before and during COVID-19 in the United States. Front Public Health 2023; 11:1112575. [PMID: 37250079 PMCID: PMC10213641 DOI: 10.3389/fpubh.2023.1112575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 03/29/2023] [Indexed: 05/31/2023] Open
Abstract
Background The COVID-19 pandemic has strained the health and wellbeing of older adult populations through increased morbidity, mortality, and social exclusion. However, the impact of COVID-19 on the health of older adults through food security has received relatively little attention, despite the strong impact of diet quality on the health and longevity of older adults. Objective The objective of this study was to identify sociodemographic and socioeconomic predictors of self-reported food insecurity before and early in the COVID-19 pandemic among community-dwelling older adults in the United States. Methods Using longitudinal data from the Health and Retirement Study, a nationally representative sample of middle-aged and older adults in the United States, we examined the associations between sociodemographic and socioeconomic predictors of self-reported food insecurity between 2018 (N = 2,413) and June 2020 (N = 2,216) using population-weighted multivariate logistic regression models. Results The prevalence of food insecurity doubled among participants from 2018 (4.83%) to June 2020 (9.54%). In 2018, non-Hispanic Black and rural residents were more likely to report food insecurity, while individuals with higher education and greater wealth were less likely to report food insecurity in adjusted models. In June 2020, those who were relatively younger, not working due to a disability, and renting were more likely to report food insecurity. Those with an increased number of functional limitations, a recent onset of a work-limiting disability, and those who were no longer homeowners experienced an elevated longitudinal risk for food insecurity. Conclusion Future research should examine effective policies and interventions to address the disproportionate impacts of COVID-19 on populations at a heightened risk of experiencing food insecurity.
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Affiliation(s)
- Emily Joy Nicklett
- Department of Social Work, College for Health, Community and Policy, University of Texas at San Antonio, San Antonio, TX, United States
| | - Greta Jianjia Cheng
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
| | - Zachary A. Morris
- School of Social Welfare, Stony Brook University, Stony Brook, NY, United States
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Vargas-Vázquez C, González-Ortíz A, Bertrán-Vilà M, Espinosa-Cuevas A. Impact of SARS-CoV-2 Pandemic on food Security in Patients With chronic Kidney Disease. J Ren Nutr 2023; 33:78-87. [PMID: 35863603 PMCID: PMC9293391 DOI: 10.1053/j.jrn.2022.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/16/2022] [Accepted: 07/03/2022] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE The present study aims to determine the degree of Food Insecurity (FI) in adult patients with CKD during the COVID-19 pandemic, as well as the association between FI and food consumption. METHODS A cross-sectional study was conducted on patients with chronic kidney disease (CKD), with and without substitutive treatment, and older than 18 years of age. Food security was measured using the Mexican Food Security Scale (MFSS). Sociodemographic data and a food frequency questionnaire were obtained. Multinomial logistic regression was performed using the 4 categories of food security (food security as reference); principal component analysis was also performed to assess the relationship between food consumption patterns and sociodemographic characteristics. RESULTS The prevalence of FI in patients with CKD was 71.6%, the most prevalent degree of FI was moderate. As FI increased, a greater amount of beans, eggs, sweets/desserts, soft drinks, and artificial juices (P < .001) was consumed. The risk factors of FI were diabetes, hypertension, unpaid occupation, living in the country's capital, having children at home, or a decrease in income due to the pandemic. Four main components were identified that were associated with the different degrees of FI. CONCLUSION The present study allowed us to conclude that more than 70% of CKD patients in the study cohort had some type of FI, which makes it difficult to adhere to treatment and may increase the risk of advanced CKD. A less healthy food pattern is associated with greater FI.
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Affiliation(s)
- Cristina Vargas-Vázquez
- Nephrology and Mineral Metabolism Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Miriam Bertrán-Vilà
- Health Care of Department Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico
| | - Angeles Espinosa-Cuevas
- Nephrology and Mineral Metabolism Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico,Health Care of Department Universidad Autónoma Metropolitana-Xochimilco, Mexico City, Mexico,Address correspondence to Angeles Espinosa-Cuevas, PhD, MCN, RD, Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Vasco de Quiroga No. 15, Col. Belisario Domínguez Sección XVI, Deleg. Tlalpan, CP 14000, Mexico City, México
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Bergmans RS, Loewenstein E, Aboul-Hassan D, Chowdhury T, Schaefer G, Wegryn-Jones R, Xiao LZ, Yu C, Moore MN, Kahlenberg JM. Social determinants of depression in systemic lupus erythematosus: A systematic scoping review. Lupus 2023; 32:23-41. [PMID: 36274579 PMCID: PMC9812916 DOI: 10.1177/09612033221135145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Social determinants of health (SDOH) influence inequities in systemic lupus erythematosus (SLE). While these inequities contribute to overall disease experience, there is little consensus guiding our understanding of the psychological implications of SDOH in SLE. Given the paucity of evidence in this area, the aim of this scoping review was to systematically assess the volume and features of available research literature on associations of SDOH with depression in SLE over the past 20 years, from 1 January 2000 to 16 November 2021. We developed a search strategy for PubMed and EMBASE that included keywords for depression and lupus. After screening 2188 articles, we identified 22 original articles that met our inclusion criteria. At least one SDOH was associated with depression in two of the six studies with unadjusted estimates and 13 of the 16 studies with adjusted estimates. Results provide consistent but sparse evidence that SDOH are associated with depression in SLE. Additionally, depression epidemiology in SLE may differ from the general population such that depression risk is more similar across genders and racial/ethnic groups. More work is needed to identify the SDOH that have the greatest impact on depression and mental health among SLE patients, as well as how and when to intervene.
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Affiliation(s)
- Rachel S. Bergmans
- University of Michigan, Medical School, Department of Anesthesiology, Chronic Pain & Fatigue Research Center, Ann Arbor, Michigan
| | - Emma Loewenstein
- University of Michigan, College of Literature, Science, and the Arts, Ann Arbor, Michigan
| | - Deena Aboul-Hassan
- University of Michigan, College of Literature, Science, and the Arts, Ann Arbor, Michigan
| | - Tasfia Chowdhury
- University of Michigan, College of Literature, Science, and the Arts, Ann Arbor, Michigan
| | - Grace Schaefer
- University of Michigan, College of Literature, Science, and the Arts, Ann Arbor, Michigan
| | - Riley Wegryn-Jones
- University of Michigan, College of Literature, Science, and the Arts, Ann Arbor, Michigan
| | - Lillian Z. Xiao
- University of Michigan, College of Pharmacy, Ann Arbor, Michigan
| | - Christine Yu
- University of Michigan, College of Literature, Science, and the Arts, Ann Arbor, Michigan
| | - Meriah N. Moore
- University of Michigan, Medical School, Department of Internal Medicine, Division of Rheumatology, Ann Arbor, Michigan
| | - J. Michelle Kahlenberg
- University of Michigan, Medical School, Department of Internal Medicine, Division of Rheumatology, Ann Arbor, Michigan
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Vaudin AM, Moshfegh AJ, Sahyoun NR. Measuring Food Insecurity in Older Adults Using Both Physical and Economic Food Access, NHANES 2013-18. J Nutr 2022; 152:1953-1962. [PMID: 35285903 DOI: 10.1093/jn/nxac058] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/17/2021] [Accepted: 03/04/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Economic food insecurity tools are used to detect need for assistance in the general population. However, in older adults, food insecurity can also be due to factors other than economic, such as physical inability to shop or cook. OBJECTIVES We determined: 1) the proportion of older adults in the United States who experience physical and/or economic food insecurity; 2) differences in characteristics, diet quality, chronic conditions, and depression by economic and/or physical food insecurity; and 3) the relation of physical and economic food insecurity with diet quality and with depression. METHODS Data from adults aged ≥60 y of the NHANES (2013-2018) were used. Groups were created based on economic food security [measured using the USDA's Household Food Security Survey Module (HFSSM)] and physical food security (measured using questions evaluating ability to shop and cook). Depression, Healthy Eating Index (HEI-2015) score, and socioeconomic characteristics were compared by food security group. Rao-Scott χ2 tests were used to test for significant differences between categorical variables, and t tests for continuous variables. Associations between food security status, HEI-2015, and depression score were examined using linear regression analysis. RESULTS One-quarter (25.0%) of older adults had physical difficulty accessing food but were not living in economically food insecure households. Those who lived in economically food insecure households and also had physical difficulties accessing food had the lowest mean HEI-2015 score (51.7) and highest mean depression score (6.9); both were significantly lower than the mean scores of those who lived in food secure households (HEI-2015 = 57.3; depression = 2.1; P < 0.01). CONCLUSIONS Considering physical ability to shop for and prepare food when measuring food insecurity in older adults can help identify those who might need dietary and mental health support the most, and those who need food assistance but would otherwise be missed if only measuring economic access.
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Affiliation(s)
- Anna M Vaudin
- Department of Nutrition and Food Science, University of Maryland, College Park, MD, USA
| | - Alanna J Moshfegh
- Agriculture Research Service, Food Surveys Research Group, U.S. Department of Agriculture, Beltsville, Maryland, USA
| | - Nadine R Sahyoun
- Department of Nutrition and Food Science, University of Maryland, College Park, MD, USA
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Comparison of National Data Sources to Assess Preventive Care in the US Population. J Gen Intern Med 2022; 37:318-326. [PMID: 33791937 PMCID: PMC8012018 DOI: 10.1007/s11606-021-06707-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/09/2021] [Indexed: 11/30/2022]
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Kaur H, Scholl JC, Owens-Gary M. Depression and Diabetes in Workers Across the Life Span: Addressing the Health of America's Workforce-Behavioral Risk Factor Surveillance System, 2014-2018. Diabetes Spectr 2022; 35:198-206. [PMID: 35668882 PMCID: PMC9160556 DOI: 10.2337/ds21-0022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Diabetes affects nearly 12.2% of U.S. adults. Comorbid depressive symptoms among U.S. workers with diabetes are associated with increased unemployment and reduced work performance. This study examined the age-group-specific prevalence of depression among U.S. workers with self-reported diabetes and identified factors associated with depression. METHODS Data from the 2014-2018 Behavioral Risk Factor Surveillance System were used to examine the prevalence of depression among adult workers with diabetes in the United States. Relationships between depression prevalence and diabetes and demographic, physical, and behavioral risk factors were examined through bivariate and multivariable analyses. Age was categorized into four groups: 18-34, 35-54, 55-64, and ≥65 years. RESULTS The overall prevalence of self-reported depression among U.S. workers with diabetes was 17.4-30% higher than among those without diabetes. Workers with diabetes aged 18-34 years had the highest depression prevalence (28.7%) compared with other age-groups. Female workers with diabetes were significantly more likely than male workers to report depression in all age-groups. Young adult workers with diabetes who had another chronic disease were nearly three times more likely to report depression than those without another chronic condition. There were no overlapping patterns of prevalence of diabetes and depression by state. CONCLUSION Workers with diabetes are at an increased risk of depression, which can affect their overall health and productivity. These findings indicate that, among those with diabetes, young adult workers and women are most likely to have depression. Employee wellness programs may address the specific needs of individuals with diabetes and depression.
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Affiliation(s)
- Harpriya Kaur
- Division of Science Integration, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH
- Corresponding author: Harpriya Kaur,
| | - Juliann C. Scholl
- Division of Science Integration, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH
| | - Michelle Owens-Gary
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
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Beltrán S, Arenas DJ, Pharel M, Montgomery C, Lopez‐Hinojosa I, DeLisser HM. Food insecurity, type 2 diabetes, and hyperglycaemia: A systematic review and meta-analysis. Endocrinol Diabetes Metab 2022; 5:e00315. [PMID: 34726354 PMCID: PMC8754242 DOI: 10.1002/edm2.315] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/18/2021] [Accepted: 10/24/2021] [Indexed: 12/16/2022] Open
Abstract
AIMS Food insecurity (FIS) is a major public health issue with possible implications for type 2 diabetes mellitus (T2DM) risk. We conducted a systematic review and meta-analysis to explore the association between FIS and T2DM. METHODS We performed a systematic search in PubMed, Embase, Scopus, and Web of Science. All cross-sectional, peer-reviewed studies investigating the link between FIS and T2DM were included. Population characteristics, study sizes, covariates, T2DM diagnoses, and diabetes-related clinical measures such as fasting blood glucose (FBG) and HbA1c were extracted from each study. Outcomes were compared between food insecure and food secure individuals. Effect sizes were combined across studies using the random effect model. RESULTS Forty-nine peer-reviewed studies investigating the link between FIS and T2DM were identified (n = 258,250). Results of meta-analyses showed no association between FIS and clinically determined T2DM either through FBG or HbA1c: OR = 1.22 [95%CI: 0.96, 1.55], Q(df = 5) = 12.5, I2 = 60% and OR = 1.21 [95%CI: 0.95, 1.54], Q(df = 5) = 14; I2 = 71% respectively. Standardized mean difference (SMD) meta-analyses yielded no association between FIS and FBG or HbA1c: g = 0.06 [95%CI: -0.06, 0.17], Q(df = 5) = 15.8, I2 = 68%; g = 0.11 [95% CI: -0.02, 0.25], Q(df = 7) = 26.8, I2 = 74% respectively. For children, no association was found between FIS and HbA1c: g = 0.06 [95%CI: 0.00, 0.17], Q(df = 2) = 5.7, I2 = 65%. CONCLUSIONS Despite multiple proposed mechanisms linking FIS to T2DM, integration of the available literature suggests FIS is not associated with clinically determined T2DM or increases in FBG or HbA1c among adult patients.
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Affiliation(s)
- Sourik Beltrán
- Department of MedicineMassachusetts General HospitalBostonMassachusettsUSA
- Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Daniel J. Arenas
- Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | | | - Canada Montgomery
- Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | | | - Horace M. DeLisser
- Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
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Abstract
IMPORTANCE Allostatic overload, a biomarker of wear and tear, could be the potential pathway through which food insecurity leads to increased morbidity risk. OBJECTIVE To assess the association of food insecurity with allostatic load (AL) among US adults aged 50 years or older. DESIGN, SETTING, AND PARTICIPANTS A multiwave longitudinal cohort study was conducted using data from the 2006 to 2014 waves of the Health and Retirement Study in a national cohort study setting. The data comprise 26 509 person-years observations from 14 394 noninstitutionalized individuals aged 50 years or older during the study period. Data were analyzed from September 1 to December 14, 2020. EXPOSURES Moderate food insecurity (not enough money to buy the food needed) and severe food insecurity (reduced food intake due to financial constraints) measured at the household level. MAIN OUTCOMES AND MEASURES The AL score (0-9, with higher scores indicating a greater risk of physiologic dysregulation) and binary indicators of dysregulated inflammatory (C-reactive protein), cardiovascular (systolic and diastolic blood pressure, pulse rate, and cystatin C), and metabolic (hemoglobin A1c, body mass index, waist-to-height ratio, total cholesterol to high-density lipoprotein cholesterol ratio) systems. RESULTS Of 14 394 participants included in the analysis, the median age was 60 (IQR, 56-69) years, 8143 (56.6%) were women, 517 (3.6%) were moderately food insecure, and 804 (5.6%) were severely food insecure. In adjusted models, the incidence rate of AL was 1.05 (95% CI, 1.00-1.09) times higher for the participants with moderate food insecurity and 1.11 (95% CI, 1.07-1.15) times higher for the participants with severe food insecurity, compared with those who were food secure. The increased incidence rate of AL among participants with severe food insecurity was associated with C-reactive protein level (odds ratio [OR], 1.22; 95% CI, 1.04-1.44), cystatin C level (OR, 1.23; 95% CI, 1.01-1.51), hemoglobin A1c level (OR, 1.27; 95% CI, 1.01-1.59), body mass index (OR, 1.84; 95% CI, 1.41-2.40), waist-to-height ratio (OR, 1.54; 95% CI, 1.26-1.88), and total to high-density lipoprotein cholesterol ratio (OR, 1.32; 95% CI, 1.10-1.59) inflated to the high-risk range. The interaction between moderate food insecurity and Supplemental Nutrition Assistance Program (SNAP) enrollment (β = -0.18; P = .001) and the interaction between severe food insecurity and SNAP enrollment (β = -0.09; P = .02) were associated with a reduction in AL. CONCLUSIONS AND RELEVANCE In this national cohort study of US adults aged 50 years or older, food insecurity was associated with higher AL, mainly through dysregulation of the inflammatory and metabolic systems. SNAP enrollment may modify this association between food insecurity and AL.
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Affiliation(s)
- Tae-Young Pak
- Department of Consumer Science and Convergence Program for Social Innovation, Sungkyunkwan University, Seoul, South Korea
| | - GwanSeon Kim
- College of Agriculture, Arkansas State University, Jonesboro
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Abstract
BACKGROUND Food insecurity (FI) is an important public health issue for US veterans. For many veterans, civilian life is fraught with service-incurred health issues and socioeconomic challenges, each risk factors for FI. The FI literature on veterans is limited due to insufficient coverage of the topic's complexity and the methods used to study it in this population. No published analysis has evaluated how FI has been examined in US veterans. OBJECTIVES We assessed how FI has been examined in US military veterans by identifying (1) the major content areas, or domains, studied in association with FI and (2) the existing research gaps. METHODS A scoping literature review was conducted to map the main research domains of the FI literature and identify knowledge gaps. Electronic database and hand searches identified potentially relevant studies (n = 61). Data extraction, utilizing a standardized set of design parameters, was completed. Duplicate removal and application of inclusion/exclusion criteria resulted in the studies (n = 21) selected for critical review. RESULTS Eight research domains were determined: FI prevalence, health status, dietary practices, health care utilization, economic instability, homelessness/housing instability, food program participation, and community/emergency preparedness-the most dominant was health status and the least dominant were social determinants (ie, homelessness/housing instability, food program participation). Research on validity and usability of FI assessment methods in veterans was virtually absent. Military service factors, longitudinal effects, FI among women, intervention effectiveness, and other areas lacked sufficient inquiry. CONCLUSION Research is required on lesser examined content areas and methodology to optimize surveillance and policy for veteran FI.
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Affiliation(s)
- Yasmin S Cypel
- Epidemiology Program, Post-Deployment Health Services (12POP5), Office of Patient Care Services, 8267US Department of Veterans Affairs, Veterans Health Administration, Washington, DC, USA
| | - Jodie G Katon
- 49462US Department of Veterans Affairs (VA) Puget Sound Health Care System, Health Services Research and Development (HSR&D) Center of Innovation for Veteran-Centered and Value-Driven Care, Seattle, WA, USA.,Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA
| | - Mark B Schure
- Department of Health & Human Development, 1705Montana State University, Bozeman, MT, USA
| | - Shanna Smith
- Epidemiology Program, Post-Deployment Health Services (12POP5), Office of Patient Care Services, 8267US Department of Veterans Affairs, Veterans Health Administration, Washington, DC, USA
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Sutin AR, Aschwanden D, Luchetti M, Stephan Y, Terracciano A. Sense of Purpose in Life Is Associated with Lower Risk of Incident Dementia: A Meta-Analysis. J Alzheimers Dis 2021; 83:249-258. [PMID: 34275900 DOI: 10.3233/jad-210364] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND A sense of purpose in life has been associated with healthier cognitive outcomes across adulthood, including risk of dementia. The robustness and replicability of this association, however, has yet to be evaluated systematically. OBJECTIVE To test whether a greater sense of purpose in life is associated with lower risk of dementia in four population-based cohorts and combined with the published literature. METHODS Random-effect meta-analysis of prospective studies (individual participant data and from the published literature identified through a systematic review) that examined sense of purpose and risk of incident dementia. RESULTS In six samples followed up to 17 years (four primary data and two published; total N = 53,499; n = 5,862 incident dementia), greater sense of purpose in life was associated with lower dementia risk (HR = 0.77, 95%CI = 0.73-0.81, p < 0.001). The association was generally consistent across cohorts (I2 = 47%), remained significant controlling for clinical (e.g., depression) and behavioral (e.g., physical inactivity) risk factors, and was not moderated by age, gender, or education. CONCLUSION Sense of purpose is a replicable and robust predictor of lower risk of incident dementia and is a promising target of intervention for cognitive health outcomes.
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Affiliation(s)
- Angelina R Sutin
- Florida State University College of Medicine, Tallahassee, FL, USA
| | | | - Martina Luchetti
- Florida State University College of Medicine, Tallahassee, FL, USA
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15
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The Relationship between Food Security Status and Sleep Disturbance among Adults: A Cross-Sectional Study in an Indonesian Population. Nutrients 2020; 12:nu12113411. [PMID: 33172042 PMCID: PMC7694601 DOI: 10.3390/nu12113411] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/04/2020] [Accepted: 11/04/2020] [Indexed: 02/06/2023] Open
Abstract
Background: The relationship between food insecurity and the experience of sleep disturbance has received little attention among researchers, although food insecurity is associated with poor physical and mental health globally. This study aimed to investigate the relationship between food security status and sleep disturbance among adults 20–64 years old. Methods: The study’s population-based sample included 20,212 Indonesian adults who participated in the fifth wave of the Indonesia Family Life Survey (IFLS5) in 2014. Dietary intake data, gathered using a food frequency questionnaire (FFQ), were used to assess the food security status. Sleep disturbance was assessed using the 10-item Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaire. We used multiple linear and logistic regression models to test the study hypothesis. Results: A higher likelihood of experiencing sleep disturbance was recorded in people aged older than 56 years (OR = 1.78, 95% CI: 1.17–2.72, p = 0.007), people with depressive symptoms (OR = 3.57, 95% CI: 2.77–4.61, p < 0.001), and food-insecure people (OR = 1.32, 95% CI: 1.02–1.70, p = 0.036). A lower likelihood of experiencing sleep disturbance was recorded in people with low educational attainment (OR = 0.41, 95% CI: 0.30–0.57, p < 0.001). Sleep disturbance was dependent on the food consumption groups and food security status among men (p = 0.004). Conclusions: Sleep disturbance may be affected by the food-insecure status of adults, and later, may lead to serious health outcomes.
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16
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McKay FH, Haines BC, Beswick H, McKenzie H, Lindberg R. The prevalence, severity and experience of food insecurity in Australia: An investigation of food aid use. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:2399-2407. [PMID: 32562318 DOI: 10.1111/hsc.13062] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 04/07/2020] [Accepted: 05/21/2020] [Indexed: 06/11/2023]
Abstract
High costs of living and low wage growth in Australia have resulted in an increase in the number of people experiencing food insecurity, and a corresponding increase in the number of people accessing food aid. This research employs qualitative methods alongside standard methods to explore food security to investigate these issues in food aid settings in Victoria, Australia. The two aims of this study were, 1) to explore the profile of people who access food aid and 2) to explore the experiences of people accessing food aid. A convenience sample of people was recruited from organisations that distribute food aid from across the state. People in need of food aid typically self-refer to charities, who then apply varied and localised criteria to manage access to the charitable service. Interviews were conducted with 78 participants between June 2018 and January 2019. Participants had been accessing food aid for 4 years on average (SD 5.7, range 1 month-40 years), most participants were female (n = 57, 73.1%), with an average age of 52.6 years (SD 15.9), and over half were born in Australia (n = 44, 56.4%). Most participants were in receipt of a government welfare payment (n = 75, 96.2%), and over 40% were living in private rental accommodation. Around two thirds of participants reported low or very low food security (n = 54, 67.5%). Participants reported a range of both positive and negative experiences accessing food aid. This study adds to the body of literature exploring food insecurity in high-income settings and its persistence despite significant national economic prosperity. Current economic and political conditions in Australia mean that the reliance on food aid by welfare recipients is unlikely to decrease.
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Affiliation(s)
- Fiona H McKay
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Bronte C Haines
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Holly Beswick
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Hayley McKenzie
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Rebecca Lindberg
- The Institute for Physical Activity and Nutrition (IPAN) and School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Geelong, VIC, Australia
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17
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Bergmans RS, Wegryn-Jones R. Examining associations of food insecurity with major depression among older adults in the wake of the Great Recession. Soc Sci Med 2020; 258:113033. [PMID: 32535473 PMCID: PMC7363549 DOI: 10.1016/j.socscimed.2020.113033] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/30/2020] [Accepted: 05/11/2020] [Indexed: 12/27/2022]
Abstract
As a psychosocial stressor, the degree to which food insecurity impacts major depression may be dependent on macro-level context, which can be examined in the wake of the Great Recession. The objective of this study was to determine (1) whether food insecurity transition status (i.e. initially food insecure, becoming food insecure, and remaining food insecure vs. not food insecure) was associated with major depression in older adults and; (2) whether this association was moderated by macro-level context. Data came from the United States Health and Retirement Study, 2008-2016. Multivariable logistic regression across all years revealed that major depression was associated with any exposure to food insecurity, however; this association was moderated by time period. Remaining food insecure was associated with major depression during all time periods. In contrast, becoming food insecure was associated with major depression in the years during and immediately following the Recession, but not in later time periods. Findings suggest that associations of food insecurity with major depression among older adults are moderated by macro-level context, consistent with theories of social comparison and relative disadvantage. Food insecurity may represent an important risk factor for major depression and mental health disparities across socioeconomic strata in old age. Thus, policies that increase access to food assistance programs or improve the quality of local food environments may buffer against the impact of food insecurity on depression and associated complications among older adults.
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Affiliation(s)
| | - Riley Wegryn-Jones
- University of Michigan, College of Literature, Science, and the Arts, USA
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18
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Walker RJ, Garacci E, Palatnik A, Ozieh MN, Egede LE. The Longitudinal Influence of Social Determinants of Health on Glycemic Control in Elderly Adults With Diabetes. Diabetes Care 2020; 43:759-766. [PMID: 32029639 PMCID: PMC7085811 DOI: 10.2337/dc19-1586] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 01/13/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study aimed to understand the longitudinal relationship between financial, psychosocial, and neighborhood social determinants and glycemic control (HbA1c) in older adults with diabetes. RESEARCH DESIGN AND METHODS Data from 2,662 individuals with self-reported diabetes who participated in the Health and Retirement Study (HRS) were used. Participants were followed from 2006 through 2014. Financial hardship, psychosocial, and neighborhood-level social determinant factors were based on validated surveys from the biennial core interview and RAND data sets. All social determinant factors and measurements of HbA1c from the time period were used and treated as time varying in analyses. SAS PROC GLIMMIX was used to fit a series of hierarchical linear mixed models. Models controlled for nonindependence among the repeated observations using a random intercept and treating each individual participant as a random factor. Survey methods were used to apply HRS weighting. RESULTS Before adjustment for demographics, difficulty paying bills (β = 0.18 [95% CI 0.02, 0.24]) and medication cost nonadherence (0.15 [0.01, 0.29]) were independently associated with increasing HbA1c over time, and social cohesion (-0.05 [-0.10, -0.001]) was independently associated with decreasing HbA1c over time. After adjusting for both demographics and comorbidity count, difficulty paying bills (0.13 [0.03, 0.24]) and religiosity (0.04 [0.001, 0.08]) were independently associated with increasing HbA1c over time. CONCLUSIONS Using a longitudinal cohort of older adults with diabetes, this study found that financial hardship factors, such as difficulty paying bills, were more consistently associated with worsening glycemic control over time than psychosocial and neighborhood factors.
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Affiliation(s)
- Rebekah J Walker
- Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI
| | - Emma Garacci
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI
| | - Anna Palatnik
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI
- Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI
| | - Mukoso N Ozieh
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI
- Division of Nephrology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Leonard E Egede
- Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
- Center for Advancing Population Science, Medical College of Wisconsin, Milwaukee, WI
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Isaura ER, Chen YC, Adi AC, Fan HY, Li CY, Yang SH. Association between Depressive Symptoms and Food Insecurity among Indonesian Adults: Results from the 2007-2014 Indonesia Family Life Survey. Nutrients 2019; 11:E3026. [PMID: 31835825 PMCID: PMC6950164 DOI: 10.3390/nu11123026] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 12/05/2019] [Accepted: 12/10/2019] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Depressive symptoms and food insecurity are two of the public health concerns in developing countries. Food insecurity is linked to several chronic diseases, while little is known about the association between food insecurity and depressive symptoms among adults. A person with limited or uncertain availability or access to nutritionally sufficient, socially relevant, and safe foods is defined as a food-insecure person. MATERIALS AND METHODS Data were obtained from 8613 adults who participated in the Indonesia Family Life Survey (IFLS) in 2007 and 2014. The 10 items of the food frequency questionnaire (FFQ) were used in food consumption score analysis to assess food insecurity based on the concept of the World Food Program (WFP). Depressive symptoms were assessed using 10 items of the self-reported Center for Epidemiologic Studies Depression (CES-D) questionnaire. A linear and multiple logistic regression model with a generalized estimating equation was used to test the hypothesis while accounting for the health behaviors and sociodemographic characteristics. RESULTS Food consumption score was negatively associated with CES-D 10 score (β-coefficients: -9.71 × 10-3 to -1.06 × 10-2; 95% CIs: -7.46 × 10-3 to -1.26 × 10-2). The borderline and poor food consumption group was positively associated with the depressive symptoms, both in the unadjusted and adjusted models (exponentiated β-coefficients: 1.13 to 1.18; 95% CIs: 1.06 to 1.28). Conclusions: Depressive symptoms were positively significantly associated with food insecurity. Thus, health professionals must be aware of the issue, and should consider health and nutrition programs for adults at risk of food insecurity.
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Affiliation(s)
- Emyr Reisha Isaura
- Department of Nutrition, Faculty of Public Health, Airlangga University, Surabaya, East Java 60115, Indonesia; (E.R.I.); (A.C.A.); (C.-Y.L.)
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan;
| | - Yang-Ching Chen
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan;
- Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Department of Family Medicine, Taipei Medical University Hospital, Taipei 11031, Taiwan;
| | - Annis Catur Adi
- Department of Nutrition, Faculty of Public Health, Airlangga University, Surabaya, East Java 60115, Indonesia; (E.R.I.); (A.C.A.); (C.-Y.L.)
- Research Center of Food Science and Technology, Rumah Inovasi Natura, Surabaya, East Java 60112, Indonesia
| | - Hsien-Yu Fan
- Department of Family Medicine, Taipei Medical University Hospital, Taipei 11031, Taiwan;
| | - Chung-Yi Li
- Department of Nutrition, Faculty of Public Health, Airlangga University, Surabaya, East Java 60115, Indonesia; (E.R.I.); (A.C.A.); (C.-Y.L.)
- Department and Graduate Institute of Public Health, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Shwu-Huey Yang
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan;
- Nutrition Research Center, Taipei Medical University Hospital, Taipei 11031, Taiwan
- Research Center of Geriatric Nutrition, College of Nutrition, Taipei Medical University, Taipei 11031, Taiwan
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20
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Bergmans RS, Coughlin L, Wilson T, Malecki K. Cross-sectional associations of food insecurity with smoking cigarettes and heavy alcohol use in a population-based sample of adults. Drug Alcohol Depend 2019; 205:107646. [PMID: 31677489 PMCID: PMC6918825 DOI: 10.1016/j.drugalcdep.2019.107646] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 09/16/2019] [Accepted: 09/17/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Smoking, alcohol abuse and dual substance use represent significant public health problems and are thought to contribute to significant disparities in morbidity and mortality in the United States. Associations of food insecurity with these substances are poorly characterized, particularly concerning heavy alcohol consumption and dual substance use. Additionally, demographic factors may moderate these associations. METHODS In a cross-sectional, representative sample of Wisconsin adults (n = 1616), logistic regression was used to examine whether food insecurity was associated with cigarette smoking, heavy alcohol use and dual substance use. Interactions of food insecurity with gender, marital status and age group tested moderation by demographic factors. PRINCIPAL FINDINGS Food insecurity was associated with cigarette smoking in men and women (odds ratio (OR) = 3.0, 95% confidence interval (CI) = 2.1-4.4); however, only among men was food insecurity associated with heavy alcohol use (OR = 1.5; 95% CI = 1.0-2.2) and dual substance use (OR = 5.2; 95% CI = 1.5-18.6). Marital status and age group did not moderate associations of food insecurity with substance use. CONCLUSIONS Food insecurity and substance use are highly correlated. Heavy alcohol consumption and dual use were positively correlated with food insecurity among men, but not among women. Longitudinal analyses are needed to disentangle temporality and underlying pathways of observed associations. Additionally, future work should determine whether interventions and policies targeting food insecurity can simultaneously reduce cigarette and alcohol use.
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Affiliation(s)
- Rachel S Bergmans
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA.
| | - Lara Coughlin
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Tomorrow Wilson
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Kristen Malecki
- Population Health Sciences Department, University of Wisconsin-Madison, Madison, WI, USA
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21
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Bergmans RS. Food insecurity transitions and smoking behavior among older adults who smoke. Prev Med 2019; 126:105784. [PMID: 31325523 PMCID: PMC6737935 DOI: 10.1016/j.ypmed.2019.105784] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 07/15/2019] [Accepted: 07/17/2019] [Indexed: 12/30/2022]
Abstract
Cross-sectional data reveal that smoking cigarettes is highly prevalent among those who are food insecure. However, there is limited and conflicting evidence concerning whether causal factors may influence associations of food insecurity with smoking behavior. Additionally, temporality is a core feature of food insecurity that should be considered when examining linkages between food insecurity and health behaviors like smoking cessation. In 2019, data were extracted from waves 2012 and 2014 of the Health and Retirement Study-a representative sample of U.S. adults ≥50. Analyses were limited to those who smoked cigarettes in 2012 (n = 2197). Food insecurity was assessed in 2012 and 2014 to indicate food insecurity transitions: (1) initially food insecure (food insecure in 2012 only); (2) became food insecure (food insecure in 2014 only); (3) remained food insecure (food insecure in 2012 and 2014), and; (4) not food insecure (reference group). Multivariable logistic regression examined odds of smoking cessation in 2014 due to food insecurity transition. Becoming food insecure was associated with a 2.0 (95% confidence interval = 1.1-3.4) higher odds of smoking cessation. Employment loss or retirement (p < 0.020) and diagnosis of a new chronic condition (p = 0.026) were also associated with higher odds of smoking cessation. In older U.S. adults, smoking cessation was associated with decreased spending power and new health problems. Future studies should examine whether findings of this study may be similar among younger adults and; whether those who quit smoking due to food insecurity are more susceptible to relapse than those who quit due to other factors.
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Affiliation(s)
- Rachel S Bergmans
- University of Michigan Medical School, Department of Psychiatry, Ann Arbor, MI 48109, United States of America.
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Bergmans RS, Mezuk B, Zivin K. Food Insecurity and Geriatric Hospitalization. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16132294. [PMID: 31261648 PMCID: PMC6651817 DOI: 10.3390/ijerph16132294] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 06/26/2019] [Accepted: 06/27/2019] [Indexed: 12/14/2022]
Abstract
Food insecurity (FI) has been associated with hospitalization, although the pathways underlying this relationship are poorly understood, in part due to the potential for a bidirectional relationship. This study aimed to determine associations of FI with concurrent and future hospitalization among older adults; mediation by depression and; whether hospitalization increased risk of FI. Participants came from the 2012 and 2014 waves of the Health and Retirement Study (HRS; n = 13,664). HRS is a prospective cohort representative of U.S. adults over the age of 50. Primary analyses included those who were not hospitalized in 2012 (n = 11,776). Not having enough money to buy necessary food or eating less than desired defined food insecurity. The Composite International Diagnostic Interview Short Form provided depression symptomology. Logistic and linear regression examined concurrent and longitudinal associations of FI in 2012 and 2014 with hospitalization in 2014. Path analysis tested mediation of FI with hospitalization frequency by depression symptomology. Finally, logistic regression examined whether hospitalization in 2012 was longitudinally associated with FI in 2014. FI was not associated with future hospitalization (odds ratio (OR) = 1.1; 95% confidence interval (CI) = 0.9–1.4), however; FI was associated with concurrent hospitalization status (OR = 1.4; 95% CI = 1.1–1.8). Depression symptomology explained 17.4% (95% CI = 2.8–32.0%) the association of FI with concurrent hospitalization frequency. Additionally, hospitalization was associated with becoming food insecure (OR = 1.5; 95% CI = 1.2–2.0). Findings may inform best practices for hospital discharge among older adults.
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Affiliation(s)
- Rachel S Bergmans
- Department of Psychiatry, Medical School, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Briana Mezuk
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Kara Zivin
- Department of Psychiatry, Medical School, University of Michigan, Ann Arbor, MI 48109, USA
- Department of Veterans Affairs, Health Services Research and Development, Center for Clinical Management Research, Ann Arbor, MI 48109, USA
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