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

Objectives. 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. Methods. 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. Results. 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; P for trend = .50), CIND (HR = 1.46; 95% CI = 1.13, 1.88; P for trend = .03), and CIND or dementia (HR = 1.47; 95% CI = 1.16, 1.87; P for trend = .02). Unprocessed or minimally processed food consumption was associated with lower risks of these outcomes. Conclusions. Increased UPF consumption is associated with higher risks of dementia, CIND, and CIND or dementia among US older adults. Public Health Implications. Our findings suggest a potential need to reduce UPF consumption for maintaining cognitive health among older adults. (Am J Public Health. 2026;116(7):981-992. https://doi.org/10.2105/AJPH.2026.308505).