Socioeconomic disparities and nutritional aging: how food insecurity and financial hardship accelerate health decline in older adults

This narrative review examines how socioeconomic disparities accelerate health decline in older adults. As the global population ages, older age represents a major risk factor for chronic diseases, frailty, and disability, particularly in socially disadvantaged groups. While adequate nutrition is essential to healthy aging, approximately 28% of the global population experiences moderate or severe food insecurity, with older adults disproportionately affected in resource-limited settings. Food insecurity and financial hardship are consistently associated with poorer diet quality, including lower Healthy Eating Index scores (e.g., ~51 vs. >57 in food-secure peers), and increased risk of adverse outcomes such as sarcopenia, frailty, and cognitive decline. Notably, food-insecure older adults are also more likely to experience overweight or obesity (OR ≈ 1.29), reflecting reliance on energy-dense, nutrient-poor diets. These disparities are shaped by structural and socioeconomic factors, including low income, limited education, inadequate social safety nets, and inequitable neighborhood food environments. Addressing these challenges requires a shift from individual-level interventions to systemic, interdisciplinary, and culturally-tailored approaches.