Childhood Sexual Trauma and Subjective Cognitive Decline: An Assessment of Racial/Ethnic and Sexual Orientation Disparities

Abstract

Prior studies examining the association between childhood sexual abuse (CSA) and subjective cognitive decline (SCD) are limited. The aim of this study was to examine the racial/ethnic and sexual orientation disparities in the association between CSA and SCD. Using data from the 2019 Behavioral Risk Factor Surveillance System Survey, crude and multivariable logistic regression models were used to determine the association between CSA and SCD adjusting for sociodemographic characteristics, diabetes, hypertension, and depression. There were statistically significant differences in CSA status by age, gender, income, education, employment, and health status (depression). Black and Hispanic/Latine respondents had a stronger relationship between CSA and SCD compared to White populations. Also, sexual minority populations had a stronger relationship between CSA and SCD compared to heterosexual populations. Health disparities exist in the association between CSA and SCD. Trauma-informed interventions should be implemented among affected populations.

Neurocognitive health in LGBTQIA+ older adults: current state of research and recommendations

“…This strategy has enabled investigations of large samples with good statistical power. But SOGI variables are included in only a few large population-based studies (e.g., Health and Retirement Study, Behavioral Risk Factor Surveillance System, Canadian Longitudinal Study on Aging, National Health Interview Survey) that have been repeatedly exploited (Flatt et al, 2018 ; Seelman, 2019 ; Brown and Patterson, 2020 ; Nelson and Andel, 2020 ; Hsieh et al, 2021 ; Liu et al, 2021 ; Stinchcombe and Hammond, 2021 , 2023 ; Fredriksen-Goldsen et al, 2022 ; Brown et al, 2023 ; Hopper et al, 2023 ; Stinchcombe et al, 2023 ). Possible overlaps between samples across these studies with consequences on biased estimations of SOGI-related effects on cognitive outcome measures cannot be ruled out.…”

“…A high degree of methodological heterogeneity characterizes the definition of SGM groups. While most studies used selfidentified sexual orientation (Seelman, 2019;Brown and Patterson, 2020;Nelson and Andel, 2020;Flatt et al, 2021;Hsieh et al, 2021;Saunders et al, 2021;Hammond, 2021, 2023;Fredriksen-Goldsen et al, 2022;Brown et al, 2023;Hopper et al, 2023;Yang et al, 2024), some focused on either sexual attraction (Manca and Venneri, .…”

“…SCD is the outcome measure most commonly studied for aging SGM groups, often operationalized as a binary variable based on self-rated worsening in memory and/or thinking abilities (Seelman, 2019 ; Brown and Patterson, 2020 ; Nelson and Andel, 2020 ; Brown et al, 2023 ). Although this approach may provide useful exploratory findings to guide future investigations, the SCD diagnostic label is a poor indicator of risk of cognitive impairment if not substantiated either by biomarkers or by follow-up assessments to confirm objective cognitive decline.…”

Altered functional connectivity of insular subregions in subjective cognitive decline

“…SCD was defined using the following question: “Over the past 12 months, have you experienced confusion or memory loss that is occurring more frequently or worsening?” This question was exclusively posed to participants aged 45 and above. It has been used in numerous studies ( Brown et al, 2023 ) as a measure of SCD within the previous year. The SCD variable was categorized as “Yes” vs. “No.” The HCs were recruited from the local community through recruitment advertisements.…”

“…This question was exclusively posed to participants aged 45 and above. It has been used in numerous studies (Brown et al, 2023) as a measure of SCD within the previous year. The SCD variable was categorized as "Yes" vs. "No. "…”