Correlates of Subjective Cognitive Decline in Lesbian, Gay, Bisexual, and Transgender Older Adults

Article type: Research Article

Authors: Flatt, Jason D.^{a; b; *} | Johnson, Julene K.^{a; b} | Karpiak, Stephen E.^{c; d} | Seidel, Liz^{c; e} | Larson, Britta^f | Brennan-Ing, Mark^{d; g}

Affiliations: [a] University of California, San Francisco (UCSF), San Francisco, CA, USA | [b] UCSF Center for Aging in Diverse Communities, San Francisco, CA, USA | [c] ACRIA Center on HIV and Aging at GMHC, New York, NY, USA and San Francisco, CA, USA | [d] New York University College of Nursing, New York, NY, USA | [e] Fordham University, New York, NY, USA | [f] Center on Halsted, Chicago, IL, USA | [g] Brookdale Center for Healthy Aging, Hunter College, City University of New York, New York, NY, USA

Correspondence: [*] Correspondence to: Jason Flatt, PhD, MPH, Institute for Health and Aging, University of California, San Francisco, 3333 California Street, Suite 340, San Francisco, CA 94118, USA. Tel.: +1 415 476 9477; E-mail: Jason.Flatt@ucsf.edu.

Abstract: Background:Little is known about subjective cognitive decline (SCD) in lesbian, gay, bisexual, and transgender (LGBT) older adults. Objectives:To examine SCD and its association with dementia risk factors, other physical and psychosocial health factors in LGBT older adults. Methods:A cross-sectional study of SCD was conducted with LGBT older adults, aged 50 and older (n = 210). SCD was categorized based on endorsement of memory problems and one other cognitive domain. Hierarchical logistic regression examined the associations between demographic factors, dementia risk factors, other health and psychosocial factors, and SCD. Results:Nearly 25% of LGBT older adults were classified as having SCD. LGBT older adults who were people of color (OR = 2.5; 95% CI = 1.1– 7.8), depressed (OR = 2.9; 95% CI = 1.3– 6.9), or reported having functional impairment (OR = 2.6; 95% CI = 1.1– 6.5) were significantly more likely to be classified as having SCD (Nagelkerke pseudo R2 = 0.27). Conclusion:Depression and functional impairment should be considered when screening LGBT older adults for cognitive impairment and dementia. Future research on the cognitive impairment and dementia risk in LGBT older adults is needed.

Keywords: Dementia, depression, risk factors, sexual minorities, subjective cognitive decline, subjective memory impairment

DOI: 10.3233/JAD-171061

Journal: Journal of Alzheimer's Disease, vol. 64, no. 1, pp. 91-102, 2018