Financial and food insecurity linked to poorer cognition in midlife women

An observational analysis published in Menopause examined psychosocial supports, stressors, and subsequent cognition among 492 parous women in the longitudinal Project Viva cohort. Questionnaires were collected in 2019–2022, followed by cognitive testing in 2022–2024 using the Montreal Cognitive Assessment (MoCA) and Cambridge Neuropsychological Test Automated Battery (CANTAB). Mean age was 55.5 years, and 71% were postmenopausal. Models adjusted for age, education, spoken English, race, and ethnicity.

Financial and food insecurity remained associated with poorer performance on several CANTAB scales after adjustment. Difficulty paying bills was associated with lower internal z-scores for executive function (−0.37; 95% CI, −0.69 to −0.06), attention (−0.42; −0.66 to −0.18), and total CANTAB performance (−0.19; −0.35 to −0.03). Although 20% scored below 26 on MoCA, all associations between psychosocial measures and MoCA were null after demographic adjustment. Social support, perceived stress, and everyday discrimination were not associated with adjusted CANTAB outcomes. Additional adjustment for menopause status had negligible effects.

The findings highlight material insecurity as a correlate of cognitive performance in midlife women, but do not establish causality or show that addressing insecurity improves cognition. Generalizability is limited by the selected cohort: participants with cognitive assessments were more likely to be college graduates and non-Hispanic White than those without assessments. A low MoCA score alone should not be interpreted as a clinical diagnosis.