Dementia Among LGBT Adults in US Typical of General Public But Challenges May Be Greater, Report Notes

Results of a first, large-scale study into the prevalence of dementia among lesbian, gay, and bisexual older adults in the U.S. were recently announced at an Alzheimer’s conference — and while findings largely mirrored the general population, they also underscored a patient population that is vulnerable and with special challenges.

Those findings —  released as a report of the Alzheimer’s Association and the Services and Advocacy for GLBT Elders (SAGE) at the association’s recent 2018 international Alzheimer’s conference — included noting that 40 percent of lesbian, gay, and bi- and transexual (LGBT) adults ages in their 60s and 70s do not share their sexual orientation with their healthcare providers.

The study, “Dementia Prevalence Among Sexual Minority Older Adults,” examined the prevalence of dementia among 3,718 LGBT adults, ages 60 and older, taking part in  in the Kaiser Permanente Research Program on Genes, Environment, and Health (RPGEH) between January 2007 and July 2016. This is a large study of genetic and environmental factors that contribute to disease.

Dementia diagnoses were collected from medical records, and analyzed by University of California, San Francisco and Kaiser Permanente Division of Research scientists.

Among the participants, 43.6% were females and 14.1% had an education of high school or less. About 81.2% were white, 10.2% Asian, 4.4% Latino, and 3.5% were black. Thirty-eight percent identified as bisexual, 36.8% as gay, and 25.2% as lesbian.

During the 9.5 years of follow-up, about 7.4% of participants developed dementia (all sorts, including that related to Alzheimer’s). This figure is close to the 10% reported by the Alzheimer’s Association’s Alzheimer’s Disease Facts and Figures for all adults in the U.S. ages 65 and above.

Contributing factors for dementia in these LGBT adults were considered to be a high prevalence of other disorders, such as hypertension (40.2%), depression (20.8%), diabetes (16.1%), cardiovascular disease (12.7%), and stroke (6.0%).

About 2.7 million people in the U.S. over age 50 identify as a sexual minority, and this number is likely to double in the next 15 years, the report said, adding that information on the prevalence of dementia in LGBT adults who do not have HIV/AIDS  is scarce.

Other findings that its authors said could make a dementia diagnosis face particularly challenging for these adults are circumstances that include:

• LGBT older adults are often marginalized and face discrimination
• they are twice as likely to age without a spouse or partner
• they are three to four times less likely to have children, greatly limiting their opportunities for support

“Given the concerns of social isolation and limited access to friend and family caregivers, there is a strong need to create a supportive healthcare environment and caregiving resources for sexual minority adults living with dementia,” Jason Flatt, PhD, MPH, and a study author, said in a news release.

“These preliminary results are the first to describe the prevalence of dementia in sexual minority older adults,” researchers wrote. “Future studies aimed at better understanding risk and risk factors for dementia in sexual minority older adults are also needed.”