Ultraprocessed Foods and the Risk of Cognitive Impairment and Dementia in Older US Adults: 2013-2020 Health and Retirement Study.

Abstract

<b>Objectives.</b> To examine associations between ultraprocessed food (UPF) consumption and risks of dementia, cognitive impairment with no dementia (CIND), and a composite outcome of CIND or dementia in a nationally representative longitudinal study of older US adults. <b>Methods.</b> Participants were from the Health and Retirement Study (HRS 2013-2020; n = 5370). We assessed UPF intake via a semiquantitative food frequency questionnaire from the 2013 HRS Health Care and Nutrition Study. We defined cognitive impairment outcomes based on the validated Langa-Weir classification from biennial cognitive assessments (2014-2020). We used weighted Cox regression to examine associations. <b>Results.</b> Compared with quintile 1, quintile 5 of UPF intake was associated with higher risks of dementia (hazard ratio [HR] = 1.58; 95% confidence interval [CI] = 1.003, 2.48; <i>P</i> for trend = .50), CIND (HR = 1.46; 95% CI = 1.13, 1.88; <i>P</i> for trend = .03), and CIND or dementia (HR = 1.47; 95% CI = 1.16, 1.87; <i>P</i> for trend = .02). Unprocessed or minimally processed food consumption was associated with lower risks of these outcomes. <b>Conclusions.</b> Increased UPF consumption is associated with higher risks of dementia, CIND, and CIND or dementia among US older adults. <b>Public Health Implications.</b> Our findings suggest a potential need to reduce UPF consumption for maintaining cognitive health among older adults. (<i>Am J Public Health</i>. 2026;116(7):981-992. https://doi.org/10.2105/AJPH.2026.308505).