Exploring Cognitive Impairment in a Community‐Based Sample of LGBTQ+ Older Adults

Abstract

AbstractBackgroundOver three million adults aged 60+ in the U.S. identify as lesbian, gay, bisexual, transgender, queer, or another sexual and/or gender minority identity (LGBTQ+). Population‐based studies have found a higher prevalence of subjective cognitive decline among LGBTQ+ adults compared to non‐LGBTQ+ adults. Less is known about objective cognitive impairment in LGBTQ+ older adults.MethodWe recruited a community‐based sample of LGBTQ+ older adults (n = 61) from low‐income housing registries. The Telephone Interview for Cognitive Status (TICS; Brandt et al., 1988), an 11‐item screening test of global cognition. Descriptive statistics were used to summarize demographic characteristics, TICS scores, and the prevalence of cognitive impairment. We also examined associations between TICS score (adjusted for age and education) and self‐reported physical and mental health limitations.ResultMean age was 70.8 (SD = 5.8, range = 58‐84). Most reported their sex assigned at birth as male (67%), and 5% identified their gender as transgender or non‐binary. Most participants identified as lesbian or gay (85%), with 7% identifying as bisexual, and 8% queer or another sexual orientation. The majority (90%) identified as White, 7% Black, and 3% Latino. Over 62% of participants had a four‐year college degree or higher. Nearly 80% reported an annual income ≤$30,000. Common chronic health conditions included depression (57%), anxiety (48%), hypertension (46%), post‐traumatic stress disorder (26%), and human immunodeficiency virus infection (21%). About 40% (n = 24) reported problems with their memory. TICS median score was 33.0 (SD = 3.55, range = 21‐39). Nearly 43% (n = 26) may have cognitive impairment (i.e., TICS score of ≤32). A lower TICS score was associated with reporting limitations in daily activities (p = 0.02) and social activities with family and friends (p = 0.04) over the past four weeks.ConclusionOver 40% of LGBTQ+ older adults scored in the impaired range on a screening measure of global cognition. Clinically, more comprehensive evaluations would clarify the extent of decline present among the current sample. Follow‐up studies are needed to better understand the cognitive functioning of LGBTQ+ older adults as some subgroups report more memory problems relative to non‐LGBTQ+ groups. Moreover, inclusive recruitment and outreach efforts are essential so the voices of all LGBTQ+ subgroups can be accurately portrayed in clinical research.