Longitudinal food insecurity patterns and cognitive performance among midlife Latina women: Findings from the CHAMACOS Maternal Cognition Study

Background Although food insecurity (FI) has been linked to cognitive aging, few studies have examined associations in midlife or socioeconomically disadvantaged populations or considered longitudinal FI patterns. Objective To examine cross-sectional and longitudinal associations between FI and cognitive performance in a prospective cohort of midlife women. Methods We analyzed data from 512 women in the CHAMACOS Maternal Cognition Study (2018–2024). FI was measured twice (approximately 3.2 years apart) with the six-item Short Form of the USDA Household Food Security Survey Module (range: 0–6). We categorized FI cross-sectionally (secure, scores of 0–1; insecure, scores 2–6) and longitudinally (persistent security, persistent FI, new FI). Cognitive performance was assessed across multiple domains with the SOL-INCA-AD assessment. We estimated associations using linear regression adjusted for sociodemographic confounders and, among a subset, APOE ɛ4 carrier status. Results Cross-sectionally, FI was associated with lower global cognition z-scores (β = −0.11, 95% CI: −0.21, −0.01), with similar trends for executive function (β = −0.10, 95% CI: −0.19, 0.01) and memory domains (β = −0.13, 95% CI: −0.29, 0.03). Longitudinally, new FI (versus persistent security) was associated with lower scores across all domains (Global β = −0.19, 95% CI: −0.32, −0.06; Executive function β = −0.15, 95% CI: −0.27, −0.02; Memory β = −0.22, 95% CI: −0.43, −0.01; Verbal fluency β = −0.17, 95% CI: −0.36, 0.02). Persistent FI showed weaker associations. Conclusions In this cohort of midlife women, FI and particularly new onset FI were associated with worse cognitive performance after adjusting for sociodemographic and genetic confounders.