Low-income older adults are at increased risk of cutting back on basic needs, including food and medication. This study examined the relationship between food insecurity and cost-related medication non-adherence (CRN) in low-income Georgian older adults. The study sample includes new Older Americans Act Nutrition Program participants and waitlisted people assessed by a self-administered mail survey (N = 1000, mean age 75.0 + so - 9.1 years, 68.4% women, 25.8% African American). About 49.7% of participants were food insecure, while 44.4% reported practicing CRN. Those who were food insecure and/or who practiced CRN were more likely to be African American, low-income, younger, less educated, and to report poorer self-reported health status. Food insecure participants were 2.9 (95% CI 2.2, 4.0) times more likely to practice CRN behaviors than their counterparts after controlling for potential confounders. Improving food security is important inorder to promote adherence to recommended prescription regimens.

This study documents the size of unmet needs for Older Americans Act Nutrition Program (OAANP) and characteristics of program participants and waitlisted people based on the data from the Georgia client database systems. About 60% of those who requested the OAANP service between July and early November, 2008 (n = 4,952) were on waitlists. Waitlisted people, especially those on the Home-Delivered Meals (HDM) waitlist, were more likely to report poorer sociodemographic characteristics, poorer self-reported health status, food insecurity, and nutritional risk. Requesting HDM was the foremost significant factor associated with unmet needs. Other race/not disclosing race information and living alone also increased the odds of being on the waitlists. There is a critical unmet need for the OAANP in Georgia, especially among those targeted by the Older Americans Act and requesting HDM. Federal and state policy makers, administrators, and program providers should better understand and meet the need of nutritionally vulnerable older Georgians.

The Nutrition Screening Initiative DETERMINE Checklist (NSI) is used throughout the United States to assess nutrition risk of those requesting the services of the Older Americans Act Nutrition Program (OAANP). This study examined the ability of the NSI to evaluate nutrition risk by comparing the responses between NSI and matched comparable survey questions using the self-administered mail survey data that were collected among 924 new OAANP applicants in Georgia (mean age 75.0 ± 9.2 years, 68.8% women, 26.1% Black). Ninety-four percent of our sample provided at least one discordant response (i.e., disagreement between responses to the NSI and matched questions). Questions regarding food intake most frequently yielded discordant responses. Black participants were more likely to provide discordant responses for the meal frequency question. Food insecure individuals were less likely to provide discordant responses for food intake questions. Those who lived alone were less likely to provide discordant responses for the dairy intake question. Some NSI items may have limited ability to reliably assess nutritional risk of older adults. Further efforts are warranted to improve nutritional assessment tools for use in vulnerable older adults.

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Low‐income older adults are at increased risk of cutting back on basic needs, including food and medication. This study examined food insecurity and cost‐related medication non‐adherence (CRN) in a randomly selected sample of senior center participants in northeast Georgia (n=137, age 77.3±8.8 years, 82.5%women, 44.8% black). Food insecurity was assessed using the 10‐item USDA Household Food Security Survey Module. Practice of 5 CRN behaviors (e.g. splitting pills, skipping doses) and 9 other prescription cost‐cutting (PCC) behaviors (e.g. seeking free samples, importing prescriptions) over the last month were evaluated. About 8% of participants were food insecure, while 9% and 32% had utilized one or more CRN and cost‐cutting strategies, respectively. Food insecure participants were more likely to be black, less educated, and at nutritional risk. Those who practiced CRN were more likely to be at nutritional risk and to practice PCC strategies. Food insecure participants were about 14 times more likely to practice one or more CRN behaviors than their counterparts even after controlling for potential confounders. Food insecure older adults were unable to meet not only basic food needs but also basic prescription needs. Improving food security is important for low‐income older adults in order to promote adherence to recommended medication management. Funding: ADA Healthy Aging DPG Student Research Award