Association between food insecurity and depression among older adults from low- and middle-income countries

Lee Smith, Jae Il Shin, Daragh McDermott, Louis Jacob, Yvonne Barnett, Guillermo F. López-Sánchez, Nicola Veronese, Lin Yang, Pinar Soysal, Hans Oh, Igor Grabovac, Ai Koyanagi

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)

Abstract

Background: To examine the association between self-reported food insecurity and depression in 34,129 individuals aged ≥50 years from six low- and middle-income countries (LMICs) (China, Ghana, India, Mexico, Russia, and South Africa). Methods: Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health (SAGE) were analyzed. Self-reported past 12-month food insecurity was assessed with two questions on frequency of eating less and hunger due to lack of food. Questions based on the World Mental Health Survey version of the Composite International Diagnostic Interview were used for the endorsement of past 12-month DSM-IV depression. Multivariable logistic regression analysis and meta-analysis were conducted to assess associations. Results: In total, 34,129 individuals aged ≥50 years [mean (SD) age, 62.4 (16.0) years; 52.1% females] were included in the analysis. Overall, the prevalence of moderate and severe food insecurity was 6.7% and 5.1%, respectively, while the prevalence of depression was 6.0%. Meta-analyses based on countrywise estimates showed that overall, moderate food insecurity (vs. no food insecurity) is associated with a nonsignificant 1.69 (95% confidence interval [CI] = 0.82–3.48) times higher odds for depression, while severe food insecurity is significantly associated with 2.43 (95% CI = 1.65–3.57) times higher odds for depression. Conclusions: In this large representative sample of older adults from six LMICs, those with severe food insecurity were over two times more likely to suffer from depression (compared with no food insecurity). Utilizing lay health counselors and psychological interventions may be effective mechanisms to reduce depression among food-insecure populations. Interventions to address food insecurity (e.g., supplemental nutrition programs) may reduce depression at the population level but future longitudinal studies are warranted.

Original languageEnglish
Pages (from-to)439-446
Number of pages8
JournalDepression and Anxiety
Volume38
Issue number4
DOIs
Publication statusPublished - 2021 Apr

Bibliographical note

Funding Information:
This paper uses data from WHO's Study on global AGEing and adult health (SAGE). SAGE is supported by the US National Institute on Aging through Interagency Agreements OGHA 04034785, YA1323–08-CN-0020, Y1-AG-1005–01 and through research grants R01-AG034479 and R21-AG034263.

Funding Information:
This paper uses data from WHO's Study on global AGEing and adult health (SAGE). SAGE is supported by the US National Institute on Aging through Interagency Agreements OGHA 04034785, YA1323–08‐CN‐0020, Y1‐AG‐1005–01 and through research grants R01‐AG034479 and R21‐AG034263.

Publisher Copyright:
© 2021 Wiley Periodicals LLC

All Science Journal Classification (ASJC) codes

  • Clinical Psychology
  • Psychiatry and Mental health

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