Sexual Minority Disparities in Subjective Cognitive Impairment: Do They Persist After Accounting for Psychological Distress?

Abstract

Objectives: Sexual minority older adults are a health disparate group with disproportionate rates of subjective cognitive impairment (SCI) and psychological distress. This study estimated risks of SCI by sexual orientation and gender, accounting for variations in psychological distress. Methods: We aggregated National Health Interview Survey data (2013–2018) of adults aged 45 and older and implemented logistic regressions of SCI indicators on sexual orientation and psychological distress, adjusting for covariates. Results: Sexual minority adults showed higher likelihoods of SCI in terms of status, severity, frequency, extent, and activity limitations than heterosexuals, even after controlling for psychological distress. SCI risk was significantly higher among sexual minority vs. heterosexual women, with no significant difference among men. Conclusions: Public health initiatives should address this health disparity in SCI and support informal care networks for sexual minorities. Future research is needed that further investigates SCI at-risk groups, with attention to sexual minority women.

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

“…on both cognitive performance and brain metrics (e.g., volumes and functional connectivity) should be compared between SGM and non-SGM samples to clarify group-specific effects that could explain disparities. In fact, previous investigations found that depression was associated with worse cognitive performance equally in heterosexual and non-heterosexual older adults (Manca and Venneri, 2023) and that psychological distress did not explain higher rates of SCD in SGM people (Fredriksen-Goldsen et al, 2023). Future studies should also address the role of protective and resilience factors, either general (e.g., cognitive reserve (Stern et al, 2020)) or specific for SGM older adults (e.g., social support (Yang et al, 2024) and identity affirmation (Fredriksen-Goldsen et al, 2017)).…”