LGBTQ Americans were recently found 29 percent more likely to report memory loss and confusion — two early signs of dementia— than their straight, cisgender counterparts.
The research, led by the University of California, San Francisco, was released at the 2019 Alzheimer's Association International Conference in Los Angeles. A large phone-based survey was conducted across nine states. Out of more than 44,000 adults aged 45 and older, about 3 percent of participants identified themselves as a sexual or gender minority.
Researchers found that more than 14 percent of LGBTQ participants reported increased rates of subjective cognitive decline, or a self-observed experience of worsening or frequent confusion or memory loss in the past year. That's roughly one in seven adults, the study says, while the rate among straight, cisgender participants was one in ten.
Jason Flatt, an assistant professor at the Institute for Health & Aging at UCSF and the study's lead author, said his team is not certain what is causing the cognitive impairment in sexual or gender minorities. He believes it may be due to higher rates of depression, separate health concerns such as PTSD, inability to work, high stress and/or lack of access to regular health care.
For example, researchers believe that individuals with a long history of clinical depression, particularly when it goes untreated, could be at higher risk for developing dementia. Some older adults may miss signs of depression and be hesitant to communicate how they feel, but may show it through their actions.
LGBTQ adults with subjective cognitive decline were more likely to report having to give up day-to-day activities.
Another sign of dementia Flatt noted was that LGBTQ individuals had more problems with daily household tasks, such as cooking and cleaning, in comparison to straight, cisgender individuals.
"It is critical that more opportunities exist for people in these communities to receive regular evaluation for cognitive impairment and Alzheimer's disease," he said. "There is also a need for greater education on Alzheimer's risk, signs and symptoms, and training of health care providers to ensure inclusive and welcoming care for LGBTQ+ populations."
Older LGBTQ Americans are less likely to be married or have children, twice as likely to live alone and more likely not to have assistance from caregivers, than their straight, cisgender counterparts. According to researchers, these unique challenges may be connected to their cognitive decline.
Although Flatt's findings aren't directly linked with the certainty of developing dementia, he hopes the research will draw attention to a concerning trend and prompt the LGBTQ community to seek out medical care.
"Maybe it's not dementia, maybe it's something else that you could address and that could ensure that you have a healthy brain function throughout your life as your aging," Flatt told NPR.
On the other hand, talking to doctors also allows LGBTQ individuals to plan for the future.
More than 39 million Americans are seniors or older, and 2.4 million of those people identify as LGBTQ, according to the American Psychological Association. Health services specifically tailored toward LGBTQ people have been available since the 1970s. Yet elderly sexual or gender minorities still face additional barriers to health because of isolation and a lack of social services and culturally competent providers, according to the Office of Disease Prevention and Health Promotion.
"Given their lifetime experiences of victimization, discrimination and bias, many LGBT older adults forgo seeking needed medical care," according to Karen Fredriksen Goldsen, a professor at the University of Washington who's been researching the risks and the resilience of older LGBTQ adults for more than 20 years. She was not involved in the study.
Now that researchers are more aware of these disparities among elderly LGBTQ individuals, Fredriksen Goldsen said the next step is understanding what works for the community.
This is an opportunity to "start developing new ways of thinking about dementia care and Alzheimer's or memory loss than we have in the past," Fredriksen Goldsen told NPR.
She hopes to continue creating a conversation about aging to ensure that LGBTQ adults are linked with services that can properly address their needs.
About 350,000 LGBTQ adults in the U.S. are currently living with Alzheimer's disease or a related disorder.
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