Gender minority BIPOC adults in the U.S. report greater subjective cognitive decline

Abstract

AbstractBackgroundThere is limited research investigating risk of cognitive impairment and Alzheimer’s disease and related dementia (ADRD) among gender minority (GM) adults (i.e. transgender, non‐binary). To‐date, no study has examined these cognitive challenges among GM who identify as Black, Indigenous, or People of Color (BIPOC). The health and social inequities experienced by GM BIPOC are linked to an increased risk of cognitive impairment in cisgender (CG) adults. Subjective cognitive decline (SCD), a self‐reported experience of worsening memory or thinking, may be one of the first clinical manifestations of ADRD.Method2015‐2019 Behavioral Risk Factor Surveillance System data, representing 33 states that assessed SCD and gender identity, were used to create a 1:4 matched analytic sample (1GM matched to 2CG males and 2CG females on U.S. state, age, race) to examine SCD among GM BIPOC (N=129), GM White (N=324), CG BIPOC (N=513), and CG White (N=1296) adults aged 45‐65. Logistic regression and adjusted odds ratios were used to determine SCD and SCD‐associated functional limitations prevalences and test for differences in prevalence and demographic characteristics.ResultSCD prevalence was highest among GM BIPOC (26.36%) and GM White (17.90%), followed by CG BIPOC (12.28%) and CG White (9.72%). The odds of SCD were 1.64‐3.32 times higher in GM BIPOC relative to the other groups. There were no differences in prevalence of SCD‐associated limitations. After accounting for demographic characteristics, GM BIPOC adults were nearly twice as likely to report SCD when compared to both CG BIPOC (CL: 1.06–3.02, P=0.0283) and CG White adults (95% CL: 1.22–3.20, P=0.0059).ConclusionPast research highlights that BIPOC adults suffer from ADRD at higher rates than Whites. When considering the intersection of GM status and identifying as BIPOC, we found that SCD prevalence was highest among GM BIPOC and GM BIPOC had higher odds of SCD when compared to CG BIPOC. Additional studies are needed to understand correlates and modifiable risk factors of cognitive impairment among GM BIPOC adults. This understanding is necessary for identifying GM adults at higher risk for cognitive impairment, reducing ADRD risk, and improving care and quality of life for this understudied population.