AAIC 2019: Increased risk of cognitive decline observed in the LGBT community

Written by Siobhan Bennett (Future Science Group)

Very little research is known about the correlation between dementia progression and the LGBT community. The Alzheimer’s Association International Conference (AAIC; 14–18 July 2019, Los Angeles, CA, USA) is reporting multiple interesting studies exploring this, plus the first clinical intervention for LGBT people with Alzheimer’s disease (AD) and caregivers.
First study of an LGBT-specific Alzheimer’s and dementia intervention

Adults in the LGBT community have demonstrated a higher rate of cognitive impairment when compared with heterosexual adults of similar ages. To advance the research into AD in the LGBT community, Karen Fredriksen-Goldsen (University of Washington; WA, USA) created the aging with pride: innovations in dementia empowerment and action (IDEA) study.

The IDEA study is the first federation-funded study of dementia intervention designed for LGBT older adults and is a multicenter study across the USA in Seattle, San Francisco and Los Angeles. To establish the eligible participants for the study, data from 2014, 2015 and 2016 was compared and 646 individuals were identified. The main reason for ineligibility was a lack of caregiver as it has previously been reported that LGBT elders with dementia are 60% more likely to live alone. The IDEA study required both a caregiver and an elder with dementia – either of whom identified as LGBT.

“Given their lifetime experiences of victimization, discrimination and bias, many LGBT older adults forgo seeking needed medical care,” explained Fredriksen-Goldsen. “LGBT people living with dementia and their caregivers often have difficulty accessing information and support services, which can be especially challenging when memory loss and dementia enter the equation.”

LGBT older adults who have experienced discrimination and victimization show negative associations with quality of life in contrast with social activity, which enhances it. In the IDEA study, trained coaches identified and modified challenging behaviors that adversely affected the quality of life of adults living with dementia and their caregivers.

Each exercise program was individualized and included a low-impact, nine 1-hour session over 6 weeks designed to work with LGBT-specific trauma, identity management and support in the LGBT community and dementia services. Currently 225 pairs of caregivers and dementia elders are enrolled, and testing is now underway. The implications of this study are key for developing new ways to sustain collaborations with disadvantaged communities.

Abstract: Fredriksen-Goldsen K. Aging with pride, IDEA: lessons learned from the first tested clinical intervention addressing dementia and Alzheimer’s disease in the LGBT community. Presented at: Alzheimer’s Association International Conference, Los Angeles, CA, USA, 14–18 July 2019.

Risk of cognitive decline is higher among sexual and gender minorities, study indicates

Sticking with the theme of determining the association between the LGBT community and the symptoms and disease progression of AD and other dementias, Jason Flatt (University of California, San Francisco; CA, USA) analyzed data from the 2015 Behavioral Risk Factor Surveillance System – a large survey led by the Centers of Disease Control and Prevention. The data covered nine states and included 44,403 adults (mean age: 63.5 years, age range: 45–80). Approximately 3% identified as a sexual or gender minority (SGM) and the cognitive decline was categorized as self-reported confusion or memory loss that had worsened over the last year.

The analysis reported that more than 14% of SGM reported subjective cognitive decline that was significantly higher than the 10% rate among cisgender or heterosexual participants. After adjusting for factors including income, age and race, SGM participants were 29% more likely to report subjective cognitive decline. Both groups were similar in terms of reporting the cognitive defects to their healthcare provider.

“While we do not yet know for certain why sexual or gender minority individuals had higher subjective cognitive decline, we believe it may be due to higher rates of depression, inability to work, high stress, and a lack of regular access to healthcare,” Flatt concluded.

Abstract: Flatt J, Subjective cognitive decline higher among sexual and gender minorities: population-based findings from nine states in the US. Presented at: Alzheimer’s Association International Conference, Los Angeles, CA, USA, 14–18 July 2019.

You might also like:

Source: Alzheimer’s Association. Lifestyle interventions provide maximum memory benefit when combined; and may offset elevated Alzheimer’s risk due to genetics, pollution. Press release: www.alz.org/aaic/releases_2019/sunLGBT-jul14.asp