The Development of a New Scale to Measure Food Insecurity Among Older Adults Using the International Classification of Functioning, Disability, and Health (ICF) Framework

Background: Older adults face different barriers to accessing adequate food, and none of the current food security scales address the unique issues that aging could present to food security among this population.

Purpose: This study aims to understand the components of nutrition functioning in relation to food insecurity among older adults to develop a food insecurity screening tool specific to the older adult population.

Methods: Cross-sectional qualitative study with semi-structured interviews. The interviews occurred via Google Voice and were simultaneously recorded using Zoom. Two researchers coded transcriptions from interview audio recordings separately, and thematic analysis based on the International Classification of Functioning, Disability, and Health (ICF) was used to analyze the data. The findings were deliberated between all the researchers, and the final themes, subthemes, and representative quotes were mutually agreed upon.

Results: Twenty-three older adults living in independent senior living facilities were interviewed. Nine themes (transportation, access/variety, housing, mobility & aging, preparing food, interpersonal relationship, food assistance, dentition/ingestion/digestion, health conditions) and twenty-two subthemes were identified. The results demonstrated that lack of transportation, interpersonal relationships, health-related conditions, and financial constraints were this population's principal barriers to accessing and preparing adequate food.

Discussion: Food insecurity among older adults is a multi-dimension issue. A new scale to measure food insecurity among older adults was created to provide a more accurate assessment of food security risk in this population. Future research should validate this scale in different settings.