Subjective Cognitive Decline Associated with Discrimination in Medical Settings among Transgender and Nonbinary Older Adults

Nickolas H. Lambrou, Carey E. Gleason, Juno Obedin-Maliver, Mitchell R. Lunn, Annesa Flentje, Micah E. Lubensky and Jason D. Flatt
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Nickolas H. Lambrou: Division of Geriatrics, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
Carey E. Gleason: Division of Geriatrics, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA
Juno Obedin-Maliver: The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Palo Alto, CA 94304, USA
Mitchell R. Lunn: The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Palo Alto, CA 94304, USA
Annesa Flentje: Department of Community Health Systems, School of Nursing, University of California, San Francisco, CA 94143, USA
Micah E. Lubensky: Department of Community Health Systems, School of Nursing, University of California, San Francisco, CA 94143, USA
Jason D. Flatt: Institute for Health and Aging, School of Nursing, University of California, San Francisco, CA 94143, USA

IJERPH, 2022, vol. 19, issue 15, 1-11

Abstract: Background: Transgender and nonbinary (TNB) individuals report greater subjective cognitive decline (SCD) compared to non-TNB people. SCD involves self-reported problems with memory and thinking and is a potential risk for Alzheimer’s disease and related dementias (ADRD). We explored psychosocial factors, such as discrimination in medical settings, associated with SCD in a sample of TNB older adults. Methods: We utilized cross-sectional data on aging health, SCD (memory complaints and worsening memory in the past year), and discrimination in medical settings from The PRIDE Study for LGBTQ+ adults aged 50+ including TNB adults ( n = 115). Associations were tested using multivariate logistic regression. Results: Nearly 16% of TNB participants rated their memory as poor/fair, and 17% reported that their memory was worse than a year ago. TNB older adults with SCD were more likely to report experiencing discrimination in medical settings. After adjustment, those reporting discrimination in medical settings had 4.5 times higher odds of reporting worsening memory than those who did not (OR: 4.5; 95%-CI: 1.5–13.2; p = 0.006), and 7.5 times more likely to report poor/fair memory (OR: 7.49; 95%-CI: 1.7–32.8; p = 0.008); Conclusions: TNB older adults reported high frequencies of SCD and discrimination in medical settings. Further research exploring affirmative cognitive screening and healthcare services is needed.

Keywords: transgender health; subjective cognitive decline; dementia risk; risk factors; social determinants of health; health disparities (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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