Association Between Supplemental Nutrition Assistance Program Use and Memory Decline: Findings From the Health and Retirement Study.

TitleAssociation Between Supplemental Nutrition Assistance Program Use and Memory Decline: Findings From the Health and Retirement Study.
Publication TypeJournal Article
Year of Publication2023
AuthorsLu, P, Kezios, K, Lee, J, Calonico, S, Wimer, C, Hazzouri, AZeki Al
ISSN Number1526-632X
Keywordscognitive aging, government food benefits, health policy, SNAP

BACKGROUND AND OBJECTIVES: Studies on the effect of the Supplemental Nutrition Assistance Program (SNAP) on the cognitive health of older adults are scarce. We sought to examine the associations between SNAP use and memory decline among SNAP-eligible US older adults.

METHODS: Participants aged 50+ and SNAP-eligible in 1996 from the Health and Retirement Study were included. Participants' SNAP eligibility was constructed using federal criteria. Participants also self-reported whether they used SNAP. Memory function was assessed biennially from 1996 through 2016 using a composite score. To account for pre-existing differences in characteristics between SNAP users and non-users, we modeled the probability of SNAP use using demographic and health covariates. Using linear mixed-effect models, we then modeled trajectories of memory function for SNAP users and non-users using inverse probability (IP) weighting and propensity score (PS) matching techniques. In all models, we accounted for study attrition.

RESULTS: Of the 3,555 SNAP-eligible participants, a total of 15.7% were SNAP users. At baseline, SNAP users had lower socioeconomic status and a greater number of chronic conditions than non-users, and were more likely to be lost to follow-up. Our multivariable IP-weighted models (N=3,555) suggested SNAP users had worse memory scores at baseline but slower rates of memory decline compared with non-users (annual decline rate is -0.038 standardized units [95%CI=-0.044, -0.032] for users and -0.046 [95%CI=-0.049, -0.043] for non-users). Results were slightly stronger from the PS-matched sample (N=1,014) (annual decline rate was -0.046 units [95%CI=-0.050; -0.042] for users and -0.060 units [95%CI=-0.064, -0.056] for non-users). Put in other words, our findings suggested that SNAP users had about 2 fewer years of cognitive aging over a 10-year period compared with non-users.

DISCUSSION: After accounting for pre-existing differences between SNAP users and non-users as well as differential attrition, we find SNAP use to be associated with slower memory function decline.

Citation Key12812
PubMed ID36351816