LGBT adults at increased risk for subjective cognitive decline
Higher rates of subjective cognitive decline were found among the LGBT compared to cisgender heterosexual counterparts, according to study results presented at the Alzheimer’s Association International Conference. A separate study, presented at the same event, provided insight into helping older persons who identify as LGBT.
Subjective cognitive decline’s prevalence
Noting the lack of information, Jason Flatt, PhD, MPH, of the Institute for Health & Aging, School of Nursing, University of California, San Francisco, and colleagues, analyzed 2015 Behavioral Risk Factor Surveillance System data encompassing subjective cognitive decline in older adults living throughout the United States. Their sample consisted of 44,403 adults with a mean age of 63.5 years.
Researchers found that 3% of the overall sample identified as a member of the LGBT community. Of those, 14% reported subjective cognitive decline vs. 10% of cisgender heterosexuals (P < .0001) cohort. LGBT adults were 29% more likely to report subjective cognitive decline (adjusted OR = 1.29; 95% CI, 1.08-1.55) than their cisgender heterosexuals, after adjusting for demographics.
“Given the potential psychosocial challenges faced by [sexual gender minority] populations, future efforts aimed at improving early detection of cognitive impairment and Alzheimer's as well as tailoring of cognitive health interventions and supportive services should be considered,” Flatt and colleagues concluded.
Intervention addresses dementia
Karen Fredriksen-Goldsen, PhD, of the School of Social Work at the University of Washington, and colleagues examined the impact of Aging with Pride: Innovations in Dementia Empowerment and Action, or IDEA.
“As a traditionally underserved population, research has shown that the needs of LGBT older adults have not been adequately addressed in mainstream clinical trials nor established clinical services,” Fredriksen-Goldsen and colleagues wrote.
IDEA examines how a specialized LGBT-enhanced program compares to a pre-existing standard dementia program, according to researchers.
"Coaches identify and modify behavioral problems that impair function and adversely affect the care recipient and caregiver dyadic interactions based on unique risk and protective factors, and to support physical activity to increase endurance, strength, and balance,” Fredriksen-Goldsen and colleagues explained.
Researchers found that members of the LGBT community heard about IDEA through agency newsletters, community events, social media and social networks. IDEA participants also had a higher rate of living alone and were more likely to have “friends or buddy network” to encourage their engagement. The most common reason cited for not participating was not having a caregiver, and “empowerment-focused and culturally appropriate approaches” helped keep participants in the study.
“The information gained in this study has implications for the translation of evidence-based interventions for our increasingly diverse older adult population,” Fredericksen-Golden and colleagues wrote.
“This study illustrates important new ways to sustain collaborations with disadvantaged communities; recruit hard-to-reach participants; pilot-test and employ culturally appropriate instruments; and attend to the unique considerations in evaluating the efficacy and fidelity of a clinical trial in a diverse and at-risk population with differing types of care supports available,” they added. – by Janel Miller
Flatt J, et al. Subjective cognitive decline higher among sexual and gender minorities: population based findings from nine states in the U.S.
Fredericksen-Golden K, et al. Aging with pride, IDEA: Lessons learned from the first tested clinical intervention addressing dementia and Alzheimer’s disease in the LGBT Community.
Both presented at: Alzheimer’s Association International Conference. July 14-18, 2019; Los Angeles.
Disclosure s : Healio Primary Care was unable to determine the authors’ relevant financial disclosures prior to publication.