Eligible older adults who participated in the Supplemental Nutrition Assistance Program (SNAP) of government food benefits showed slower memory decline than those who didn’t participate.

SNAP users had about 2 fewer years of cognitive aging over a 10-year period compared with eligible non-users, reported Adina Zeki Al Hazzouri, PhD, epidemiologist at Columbia University Mailman School of Public Health in New York City, and colleagues.

Even though SNAP users had worse memory scores at baseline, their annual memory decline rate was slower (-0.038 standardized units, 95% CI -0.044 to -0.032) compared with their counterparts who didn’t use SNAP (-0.046, 95% CI -0.049 to -0.043), the researchers wrote in Neurology.

In a propensity score-matched sample, baseline memory function was similar between the two groups but the annual decline rate was -0.046 units (95% CI -0.050 to -0.042) for users and -0.060 units (95% CI -0.064 to -0.056) for non-users.

“While SNAP’s primary goal is to reduce food insecurity among low-income households and to increase access to higher quantity and quality foods, eating healthier may also benefit brain health,” Zeki Al Hazzouri suggested in a statement. “SNAP may also reduce stress and overall financial hardship, which has been linked to premature cognitive aging and reduced brain health.”

“In a powerful demonstration of the social determinants of health, an anti-hunger program may also be an effective anti-dementia therapy,” observed Steven Albert, PhD, of the University of Pittsburgh in Pennsylvania, in an accompanying editorial.

Although the mechanism is unclear, study findings are “robust analytically and suggest the centrality of food security, and the income that supports it, for neurologic outcomes in aging,” Albert wrote.

In 2020, over 9 million Americans in households with people 50 and older had food insecurity, Albert pointed out. “Yet most older eligible adults do not participate in the SNAP program,” he noted.

Increasing education and outreach, reducing stigma, and simplifying the application process may help increase SNAP participation rates among older adults, Zeki Al Hazzouri suggested.

The study evaluated 3,555 older adults from the ongoing Health and Retirement Study who were eligible for SNAP benefits in 1996. SNAP use was self-reported at baseline; a total of 559 people (15.7%) said they were SNAP users.

Participants had memory function measured every 2 years from 1996 through 2016 with a composite score. Memory scores ranged from -2.30 to 2.65 standardized units, with higher scores indicating better performance.

At baseline, participants in both groups were 66 years old. SNAP users had lower education and income, a higher median number of chronic conditions, and were more likely to be lost to follow-up than non-users. The researchers modeled the probability of SNAP use with demographic and health covariates to account for these differences, and used inverse probability weighting and propensity score matching to assess memory function trajectories.

The findings suggested SNAP users experienced 1.74 to 2.33 fewer years of cognitive aging over 10 years than non-users from the inverse probability model and propensity score model, respectively.

SNAP use was assessed at only one point; this may be a limitation of the study, the researchers acknowledged. However, sensitivity analyses suggested both SNAP eligibility and SNAP use were relatively stable over time.

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