Associations of food insecurity with geriatric syndromes in the economically deprived community-dwelling Chinese older adults: the mediating role of malnutrition risk.

PURPOSE: Food insecurity is a vital social determinant of health. Among the economically deprived community-dwelling Chinese older adults, we examined the associations between levels of food insecurity and (1) various types and (2) the number of geriatric syndromes, and investigated the mediating role of malnutrition risk in these relationships. METHODS: A cross-sectional study was conducted. 281 older adults aged ≥ 65 years with household income < 75% of the population median and participating in a food assistance program evaluation study in Hong Kong were included. Secondary data on food insecurity, malnutrition risk, possible sarcopenia, frailty, falls, and visual and hearing impairment were analyzed. RESULTS: The mean (SD) age was 75.5 (7.1) years and 80.4% were female. The mean (SD) food insecurity score was 0.79 (1.56). The majority (88.0%) had at least one geriatric syndrome. Logistic regressions showed that every one-point increase in the food insecurity score was significantly associated with a higher malnutrition risk [adjusted Odds Ratio (aOR): 1.94, 95% CI 1.48-2.55], possible sarcopenia (aOR: 1.41, 95% CI 1.15-1.74), falls (aOR: 1.33, 95% CI 1.11-1.61), and frailty (aOR: 1.26, 95% CI 1.02-1.56), and a 43% greater risk of having one additional geriatric syndrome (aOR: 1.43, 95% CI 1.23-1.66). The proportions of association mediated by malnutrition risk were 48.6% for possible sarcopenia, 50.0% for falls, 91.3% for frailty, and 90.5% for the number of geriatric syndromes. CONCLUSION: Food insecurity was associated with geriatric syndromes, and malnutrition risk mediated these relationships. Tackling food insecurity may combat geriatric syndromes in the community through both its direct and indirect associations.