Summary: Stress and depression may increase the risk of dementia and cognitive decline in older members of the LGBTQ community, a new study reports.

Source: Michigan State University

Lesbian, gay and bisexual — or LGB — people are more vulnerable to one of the fastest-growing health concerns in the country: dementia, according to new research from Michigan State University.

“Our study speaks to the unaddressed questions about whether members the LGB community are more likely to develop cognitive impairment at older ages and, if so, what factors contribute to their poorer cognitive health, ” said Ning Hsieh, an assistant professor of sociology at MSU and lead author of the study published in the journal, The Gerontologist.

“We knew that stress and depression are risk factors for many chronic health problems, including cognitive impairment, in later life. LGB people experience more stressful events and have higher rates of depression compared to their heterosexual counterparts,” she said.

Analyzing the elevated cognitive health risks among older members of the LGB community, the study was the first to use a national sample and screening tool to gauge cognitive health disparities between LGB and heterosexual older adults.

Hsieh and MSU colleagues Hui Liu, professor of sociology, and Wen-Hua Lai, a Ph.D. student of sociology — compared cognitive skills of 3,500 LGB and heterosexual adults using a screening tool and questionnaire that tests for six domains. Those areas included temporal orientation; language; visuospatial skills; executive function; attention, concentration and working memory; and short-term memory.

The researchers found that on average, older LGB adults were more likely to fall into categories for mild cognitive impairment or early dementia compared to heterosexual older adults. The team also tested for specific health and social factors — such as physical conditions, mental health conditions, living a healthy lifestyle and social connections — and the only factor related to cognitive differences for sexual minorities was depression.

“Our findings suggest that depression may be one of the important underlying factors leading to cognitive disadvantages for LGB people,” the researchers said. Credit: Michigan State University

“Our findings suggest that depression may be one of the important underlying factors leading to cognitive disadvantages for LGB people,” Hsieh said. “They may experience higher rates of depression than their heterosexual peers for many reasons, including not being accepted by parts of society, feeling ashamed of their sexual orientation or trying to hide their romantic relationships and being treated unfairly in school or at work.”

The researchers felt surprised that other factors — such as fewer social connections, drinking or smoking — didn’t have as great of an effect on LGB people’s cognitive function later in life. But, they also recognized the need for additional research to understand how the stressors sexual minorities experience earlier in life can lead to cognitive impairments as they age. Additionally, Hsieh said, they hope that the study’s findings shed light on the need for greater inclusivity for sexual minorities, as it can have an influence on their mental and cognitive well-being.

“Social inequality makes less privileged groups, including sexual minorities, more prone to develop cognitive impairment,” Hsieh said. “Making the society more just and more accepting of diverse sexuality may help prevent dementia and reduce related health care burden on society.”

Funding: The study was supported by the National Institute on Aging (grant R01AG061118).

About this dementia research news

Source: Michigan State University
Contact: Caroline Brooks – Michigan State University
Image: The image is credited to Michigan State University

Original Research: Closed access.
“Elevated Risk of Cognitive Impairment Among Older Sexual Minorities: Do Health Conditions, Health Behaviors, and Social Connections Matter?” by Ning Hsieh, PhD, Hui Liu, PhD, Wen-Hua Lai, MA. The Gerontologist


Abstract

Elevated Risk of Cognitive Impairment Among Older Sexual Minorities: Do Health Conditions, Health Behaviors, and Social Connections Matter?

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Background and Objectives

Little research has examined cognitive health disparities between sexual minority and heterosexual populations. Further, most extant studies rely on subjective measures of cognitive functioning and non-probability samples. This study uses a performance-based cognitive screening tool and a nationally representative sample of older Americans to examine the disparity in cognitive impairment by sexual orientation and the potential mechanisms producing this disparity.

Research Design and Methods

Using data from the 2015–2016 National Social Life, Health, and Aging Project (N = 3,567), we analyzed respondents’ scores on the survey-adapted Montreal Cognitive Assessment. We estimated ordinal logit regressions to examine the relationship between sexual orientation and cognitive impairment and used the Karlson–Holm–Breen method to assess how mental and physical conditions, health behaviors, and social connections mediate this relationship.

Results

The prevalence of cognitive impairment is significantly higher among sexual minority older adults than among heterosexual older adults when sociodemographic factors are adjusted for. Depressive symptoms explain some of this prevalence gap. Although anxiety symptoms, physical comorbidity, health behaviors, and social connections may contribute to cognitive impairment, they do not explain the cognitive disparity by sexual orientation.

Discussion and Implications

The findings indicate that depressive symptoms are an important link between minority sexual orientation and cognitive impairment and highlight the importance of studying other potential mechanisms that we could not explore in this study. Future research should further investigate how minority stress processes may unfold to accelerate cognitive decline among sexual minorities over the life course.



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