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This study uses National Health Interview Survey (NHIS) data from 2013-2018. The annual NHIS is the largest in-person houshold health survey of the non-institutionalized U.S. population, where sexual orientation began being assessed in 2013.
What is Subjective Cognitive Impairment?
Subjective Cognitive Impairment or Decline is defined as “self-reported confusion or memory loss that is getting worse” (Alzheimer’s Association & Centers for Disease Control and Prevention). In this study, Subjective Cognitive Impairment was assessed with the question “Do you have difficulty remembering or concentrating?”
Almost a quarter of sexual minority respondents self-reported difficulty remembering or concentrating, as compared to almost a fifth of heterosexual participants.
Sexual minorities that experience subjective cognitive impairment are also significantly more likely to experience their cognitive impairment as more severe and frequent, and the extent spamming more broadly across aspects of their life compared to heterosexuals.
Sexual minority adults reported being limited due to cognitive impairment at a higher rate than heterosexual adults. The odds of having cognitive impairment limitations were also higher among sexual minority women and men than their heterosexual counterparts.
Further research is needed to investigate minority-specific factors that may contribute to the onset and progression of cognitive impairment for sexual minorities. These factors include the toll of marginalization, discrimination, and victimization, as well as anxiety and depression, chronic stress, and behavioral considerations such as excessive drinking, smoking, and sleep issues. Research is also needed to further investigate the heightened risk of cognitive impairment for sexual minority women.
Public health efforts to reduce stigma related to cognitive impairment and dementia as well as related to sexual minority identities, including in healthcare settings, may lower healthcare barriers and mitigate disparities in cognitive impairment and its care. Culturally tailored interventions and policies are needed to address the unique risk factor, distinct support structures, and need for community engagement to ensure targeted and inclusive care.
Early detection is imperative in order to identify and access appropriate health care and support resources to ensure timely diagnosis and comprehensive care planning. This study reinforces the importance of clinical screening for cognitive impairment.
It is imperative to work with local and federal policy makers to include cognitive or brain health in initiatives and public health surveys such as the Behavioral Risk Factor Surveillance System. It is equally imperative to work with dementia advocacy groups, healthcare providers including physicians, nurses, and social workers, and sexual and gender diverse organizations to ensure they are educated about the importance of brain health among sexual and gender minority older adults.
Recommended citation:
Fredriksen-Goldsen, K.I. Jung, H., Kim, H.-J., Petros, R, & Emlet, C. (2022). Disparities in subjective cognitive impairment by sexual orientation and gender in a national population based study of U.S. adults, 2013-2018. Journal of Aging and Health, 34(4-5):519-528. doi:10.1177/08982643211046466
© Goldsen Institute 2023, University of Washington, Seattle, WA.
