Food insecurity and physical functioning limitations among older U.S. adults

Food insecurity among U.S. older adults has more than doubled since 2001 and is higher in those who are frail. Given the growing aging population and the importance of physical functioning and adequate food intake, the increase in food insecurity is a public health concern. This study examined the association between domains of physical limitations and food security in U.S. older adults. Data were from the National Health and Nutrition Examination Survey (2007–2012) participants 60 years of age and older (n = 5969). Physical limitations were defined as some or much difficulty on 19 activities, categorized into 5 domains and an index score. Food security status was categorized as full, marginal, low, or very low, and also dichotomized into food secure and food insecure (marginal, low, or very low food security). Multinomial and logistic regression models were used to estimate odds ratios (OR) and adjusted ORs (aOR) with food security as the dependent variable and physical limitations as independent variables. Older adults with 4 or more physical limitations were more likely to report very low food security than older adults without limitations (aOR:2.62, 95% CI:1.43, 4.81). The strongest correlates of food insecurity were Instrumental Activities of Daily Living (aOR:1.49; 95% CI:1.10, 2.01), Leisure and Social Activities (aOR:1.56; 95% CI:1.37, 2.14), and General Physical Activities (aOR:1.50; 95% CI:1.08, 2.07). Physical functioning is important for food security among older adults. Interventions should incorporate assessment of physical functioning, and provide resources for food acquisition, preparation, and intake for older adults with physical limitations.