Psycho‐social risk factors for worse cognitive performance in sexual minority older adults

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AbstractBackgroundSexual minority older adults (SMOA) may have a greater risk of developing cognitive impairment than heterosexual older adults (HOA), but currently available findings are inconsistent. Minority stress (i.e. sexual orientation‐related stigma) has been suggested to drive worse cognitive health in this population. Therefore, the present study aimed to investigate whether minority stress and other risk factors for worse cognition in SMOA, namely depression and marital status, were associated with worse cognitive performance in SMOA.MethodA total of 336 SMOA and 5561 HOA participants aged 50+, non‐institutionalised and free from neurodegenerative diseases from Wave 6 of the English Longitudinal Study of Ageing were included. Cognitive performance (i.e. temporal orientation, episodic memory and fluid intelligence) of SMOA and HOA was compared using general linear models including age, sex and education as covariates. The impact of depressive symptoms, marital status and minority stress on cognition in the two groups was also investigated. Weighting was performed to correct for sampling probability and differential non‐response.ResultSMOA were more likely to be single and to report stressful social experiences due to sexual orientation than HOA participants. SMOA had better episodic memory than HOA and depressive symptoms and being single were associated with worse cognitive performance across all tests. Associations between cognitive performance and all risk factors were found not to be significantly different between the two groups. However, minority stress was negatively associated (b = ‐2.116, p = 0.016) with fluid intelligence in the SMOA group only.ConclusionConsistently with previous evidence, the SMOA had better episodic memory performance than the HOA group and both more severe depression and not being in a relationship had a generalised detrimental impact on cognition. However, this study provided the first evidence of a potential negative impact of a proxy measure of minority stress on cognitive performance, i.e. worse fluid intelligence, in SMOA. Further investigations are needed to assess minority stress more comprehensively and to clarify the potential mechanisms driving decline in both self‐reported and objectively assessed cognitive health in SMOA.