Subjective Cognitive Decline Among Sexual and Gender Minorities: Results from a U.S. Population-Based Sample

Abstract

The risk of dementia and mild cognitive impairment between older adults in same-sex relationships and those in opposite-sex relationships have been found to be statistically not different. However, studies examining subjective cognitive decline (SCD) among sexual and gender minority populations (SGM) are lacking. The primary objective was to determine if SGM report greater subjective cognitive decline (SCD) compared to non-SGM populations in a US population-based sample of non-institutionalized adults aged 45 and older. The secondary objective was to assess the association between gender and SCD. Cross-sectional data were obtained from the 2016 Behavioral Risk Factor Surveillance System (n=36,734). There were 1,094 SGM adults in the sample. Descriptive statistics examined sociodemographic characteristics and their distribution by SCD and SGM status. Crude and multivariable logistic regression models were used to determine the association between SGM status, gender and SCD. Adjusted models controlled for age, race/ethnicity, income, education, employment, marital status, depression, and diabetes. Statistically significant differences in SGM status and SCD existed by age, race/ethnicity, education, employment, marital status and depression. Differences in SCD also existed by income and diabetes status. There was no statistically significant association between SGM status and SCD (OR: 0.88; 95% CI: 0.63 -1.24). However, men had 64% higher odds (OR: 1.64; 95%CI: 1.44 -1.88) of reporting SCD compared to women. Future studies examining the potential reasons for this null association, including resilience and/or premature aging are warranted. Future research assessing potential reasons for gender differences in SCD, whether physiological or environmental, is also needed.

Subjective cognitive decline higher among sexual and gender minorities in the United States, 2015–2018

“…Another study found higher rates of self‐reported cognitive difficulties among racial/ethnic minorities, gender minorities, and those who identified their sexual orientation as other 12 . Finally, a study using only the 2016 BRFSS found no difference in SCD by SOGI; however, only eight US states administered both the SOGI and SCD modules in 2016, which resulted in a smaller sample of SGM adults (n = 1094) compared to our study 22 …”

“…12 Finally, a study using only the 2016 BRFSS found no difference in SCD by SOGI; however, only eight US states administered both the SOGI and SCD modules in 2016, which resulted in a smaller sample of SGM adults (n = 1094) compared to our study. 22 Another study using data from the National Alzheimer's Coordinating Center found no difference in risk of objective cognitive impairment (MCI and dementia) for same-sex couples compared to opposite-sex couples. 13 The researchers noted several study limitations in terms of recruitment bias, non-probability sampling, and potential biases in reporting and ascertainment.…”

Assessing the LGBT cultural competency of dementia care providers

“…Despite many LGBT older adults experiencing dementia risk factors, the association between LGBT identity and cognitive decline remains unclear. One cross‐sectional study 11 found a lack of association between LGBT identification and SCD, and another 12 found a lack of association between LGBT identity and mild cognitive impairment and dementia. More studies are required to elucidate the impact of LGBT identity on cognitive decline.…”

“…remains unclear. One cross-sectional study 11 found a lack of association between LGBT identification and SCD, and another 12 found a lack of association between LGBT identity and mild cognitive impairment and dementia. More studies are required to elucidate the impact of…”

Subjective Functional Difficulties and Subjective Cognitive Decline in Older-Age Adults: Moderation by Age Cohorts and Mediation by Mentally Unhealthy Days

“…In the presence of functional limitations, the experience of SCD would be compounded by a lower socio-economic gradient [ 31 ]. Older age, males, and Blacks are associated with having more disrupted IADLs [ 34 ]. For instance, older men are 64% more likely to report SCD than their counterparts [ 35 ].…”