Ultra-processed food intake and impairment across multiple cognitive domains in nationally representative older U.S. adults

Introduction: Ultra-processed food (UPF) consumption, which accounts for more than 50% of energy intake in the U.S., has steadily increased among older adults over the past decade. UPF consumption is associated with overall cognitive decline, but few studies have examined the associations between UPF consumption and individual cognitive domains. In this study, we examined associations between UPF consumption and impairment in executive function, memory, language, visuospatial, and orientation using data from the longitudinal and nationally representative Health and Retirement Study (HRS). Methods: = 1,408). Dietary intake was assessed using the food frequency questionnaire from 2013 HCNS. UPF was classified using the Nova categorization. The percentage of energy intake from UPF was grouped into sex-specific quintiles (Q). Cognitive impairment was assessed from the 2016 HCAP based on cognitive domain scores, defined as >1.5 SDs below the mean or a T-score = 35. Weighted multivariate-logistic regression was used to estimate the associations between UPF consumption and cognitive outcomes. Results: In the analytic sample, mean UPF intake was 42.3% energy/day. After adjustment for baseline sociodemographic and health characteristics, higher UPF consumption showed a marginally significant trend toward greater impairment in executive function (Q4 vs. Q1, OR 2.08, 95% CI 1.16-3.74; Q5 vs. Q1, OR 1.73, 95% CI 0.97-3.09; P-trend = 0.052). UPF consumption was not significantly associated with impairment in other cognitive domains. Discussion: Our findings highlight a potential association between high UPF intake and executive functioning impairment among older U.S. adults.