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

Article type: Research Article

Authors: Brown, Monique J.^{a; b; c; d; *} | Patterson, Robert^a

Affiliations: [a] Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA | [b] South Carolina SmartState Center for Healthcare Quality, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA | [c] Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA | [d] Office for the Study on Aging, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA

Correspondence: [*] Correspondence to: Monique J. Brown, PhD, MPH, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Discovery I, 435C, Columbia, SC 29208, USA. Tel.: +1 803 777 5057; Fax: +1 803 777 2524; E-mail: brownm68@mailbox.sc.edu.

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 SCD compared to non-SGM populations in a U.S. 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.

Keywords: Cognitive dysfunction, GLBT persons, health status disparities, men, women

DOI: 10.3233/JAD-190869

Journal: Journal of Alzheimer's Disease, vol. 73, no. 2, pp. 477-487, 2020