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

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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
    Geriatric Research Education and Clinical Center, Wm S Middleton Memorial Veterans Hospital, Madison, WI 53705, USA
    Wisconsin Alzheimer’s Disease Research Center, 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
    Department of Obstetrics & Gynecology, Stanford University School of Medicine, Palo Alto, CA 94305, USA
    Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, CA 94305, USA)

  • Mitchell R. Lunn

    (The PRIDE Study/PRIDEnet, Stanford University School of Medicine, Palo Alto, CA 94304, USA
    Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, CA 94305, USA
    Division of Nephrology, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA 94305, USA)

  • Annesa Flentje

    (Department of Community Health Systems, School of Nursing, University of California, San Francisco, CA 94143, USA
    Alliance Health Project, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of California, San Francisco, CA 94102, 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
    Department of Social and Behavioral Health, School of Public Health, University of Nevada, Las Vegas, NV 89154, USA)

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.

Suggested Citation

  • Nickolas H. Lambrou & Carey E. Gleason & Juno Obedin-Maliver & Mitchell R. Lunn & Annesa Flentje & Micah E. Lubensky & Jason D. Flatt, 2022. "Subjective Cognitive Decline Associated with Discrimination in Medical Settings among Transgender and Nonbinary Older Adults," IJERPH, MDPI, vol. 19(15), pages 1-11, July.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:15:p:9168-:d:872950
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    References listed on IDEAS

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    2. Robert B. Wallace & A. Regula Herzog, 1995. "Overview of the Health Measures in the Health and Retirement Study," Journal of Human Resources, University of Wisconsin Press, vol. 30, pages 84-107.
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