Cognitive Impairment in Sexual and Gender Minority Groups: A Scoping Review of the Literature

Romanelli, Robert J.; Rosenblatt, Andrew S.; Marcum, Zachary A.; Flatt, Jason D.

doi:10.1089/lgbt.2023.0095

Cited by 6 publications

(7 citation statements)

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“…There exists an opportunity— and a necessity—to broaden the scope of research to encompass a wider arrange of specific groups. These should include sexual and gender minorities, 95, 96 indigenous populations, individuals who demonstrate resilience against cognitive decline, and those belonging to various psychiatric cohorts. Second, integrating diverse longitudinal EHR databases could expand the study population and validate findings across different institutions and geographic locations.…”

Section: Discussionmentioning

confidence: 99%

Assessing Risk Factors for Cognitive Decline Using Electronic Health Records: A Scoping Review

Wang,

Yang,

Sha

et al. 2023

Preprint

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BackgroundElectronic health records (EHR) provide rich, diverse, longitudinal real-world data, offering valuable opportunities to study antecedent risk factors for cognitive decline. However, the extent to which such records have been utilized to understand the risk factors of cognitive decline remains unclear.MethodsWe conducted a systematic review following PRISMA guidelines. We retrieved relevant articles published between January 1, 2010, and April 30, 2023, from PubMed, Web of Science, and CINAHL. Inclusion criteria were studies utilizing EHR to study risk factors for cognitive decline, including subjective cognitive decline, mild cognitive impairment, and dementia. Each article was screened by at least two reviewers. Data elements were manually extracted based on a predefined schema. The studied risk factors were reported.ResultsOf 1,593 articles identified, 80 research articles were selected. Seventy (87.5%) were retrospective cohort studies, 53 (66.3%) used datasets with greater than 10,000 patients, and 69 (86.3%) used EHR datasets from the United States or United Kingdom. Furthermore, 39 (48.8%) targeted medical conditions, 23 (28.8%) related to medical interventions, and 14 (17.5%) related to lifestyle, socioeconomic status, and environmental factors. The majority of studied medical conditions were associated with an elevated risk of cognitive decline, whereas medical interventions addressing these conditions often reduced the risk.ConclusionEHRs have significantly advanced our understanding of medical conditions, interventions, lifestyle, socioeconomic status, and environmental factors related to the risk of cognitive decline.HighlightsElectronic health records are increasingly analyzed to discern dementia risk factors.Eighty articles have been published and most of them were retrospective cohort studies.Most risk factors addressed were related to medical conditions and interventions.A few articles studied lifestyle, socioeconomic status, and environmental factors.

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Section: Discussionmentioning

confidence: 99%

Assessing Risk Factors for Cognitive Decline Using Electronic Health Records: A Scoping Review

Wang,

Yang,

Sha

et al. 2023

Preprint

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“…355 A recent review of the evidence found that most studies examining subjective cognitive decline as an outcome showed higher prevalence among SGM older adults, while those examining objective measures of cognitive performance showed more mixed results. 356 More research is necessary to establish whether SGM older adults face elevated dementia risk and if so, to understand reasons for it.…”

Section: Risk For Alzheimer's and Other Dementias In Sexual And Gende...mentioning

confidence: 99%

“…A second study of adults in Florida reported that transgender adults were more likely than cisgender adults to have a diagnosis of Alzheimer's and other dementias in their electronic medical records 355 . A recent review of the evidence found that most studies examining subjective cognitive decline as an outcome showed higher prevalence among SGM older adults, while those examining objective measures of cognitive performance showed more mixed results 356 …”

Section: Prevalencementioning

confidence: 99%

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2024 Alzheimer's disease facts and figures

2024

Alzheimer's & Dementia

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This article describes the public health impact of Alzheimer's disease (AD), including prevalence and incidence, mortality and morbidity, use and costs of care and the ramifications of AD for family caregivers, the dementia workforce and society. The Special Report discusses the larger health care system for older adults with cognitive issues, focusing on the role of caregivers and non‐physician health care professionals. An estimated 6.9 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060, barring the development of medical breakthroughs to prevent or cure AD. Official AD death certificates recorded 119,399 deaths from AD in 2021. In 2020 and 2021, when COVID‐19 entered the ranks of the top ten causes of death, Alzheimer's was the seventh‐leading cause of death in the United States. Official counts for more recent years are still being compiled. Alzheimer's remains the fifth‐leading cause of death among Americans age 65 and older. Between 2000 and 2021, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 140%. More than 11 million family members and other unpaid caregivers provided an estimated 18.4 billion hours of care to people with Alzheimer's or other dementias in 2023. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $346.6 billion in 2023. Its costs, however, extend to unpaid caregivers’ increased risk for emotional distress and negative mental and physical health outcomes. Members of the paid health care and broader community‐based workforce are involved in diagnosing, treating and caring for people with dementia. However, the United States faces growing shortages across different segments of the dementia care workforce due to a combination of factors, including the absolute increase in the number of people living with dementia. Therefore, targeted programs and care delivery models will be needed to attract, better train and effectively deploy health care and community‐based workers to provide dementia care. Average per‐person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are almost three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 22 times as great. Total payments in 2024 for health care, long‐term care and hospice services for people age 65 and older with dementia are estimated to be $360 billion. The Special Report investigates how caregivers of older adults with cognitive issues interact with the health care system and examines the role non‐physician health care professionals play in facilitating clinical care and access to community‐based services and supports. It includes surveys of caregivers and health care workers, focusing on their experiences, challenges, awareness and perceptions of dementia care navigation.

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“…Higher rates of cardiovascular disease (Caceres et al., 2017), managing chronic pain (Fredriksen‐Goldsen et al., 2017), and sleep problems were also found among older sexual minorities compared to their heterosexual counterparts (Butler et al., 2020). In addition, some studies suggested that older sexual minorities report significantly higher cognitive impairment compared to their heterosexual counterparts, although the evidence on this is somewhat mixed (Hsieh et al., 2021; Romanelli et al., 2023).…”

Section: A Life Course Perspective On Older Sexual Minoritiesmentioning

confidence: 99%

A life course perspective on sexual minorities: Implications for the study of homophobic prejudice and discrimination

Miller,

Tabor

2024

Sociology Compass

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The legal treatment of and attitudes toward sexual minorities has changed considerably over recent decades in the United States, highlighting the role of historical context in the unfolding of human lives. Yet, a full application of the life course perspective to the topic of structural inequalities faced by sexual minorities is missing from the scholarly literature. Through synthesizing and analyzing research findings from the past 15 years, we explain how the five tenets of the life course framework apply to sexual minorities, including (1) the interplay of history and human lives, (2) the timing of lives, (3) linked lives, (4) human development and aging as lifelong processes, and (5) human agency. In doing so, we argue that a life course perspective is crucial for understanding the nature and consequences of prejudice and discrimination faced by sexual minorities. We end with discussion of the need for additional research and methodological innovations regarding distinctive aging experiences, cumulative inequality, and intersectionality.

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Cognitive Impairment in Sexual and Gender Minority Groups: A Scoping Review of the Literature

Cited by 6 publications

References 40 publications

Assessing Risk Factors for Cognitive Decline Using Electronic Health Records: A Scoping Review

Assessing Risk Factors for Cognitive Decline Using Electronic Health Records: A Scoping Review

2024 Alzheimer's disease facts and figures

A life course perspective on sexual minorities: Implications for the study of homophobic prejudice and discrimination

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