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A comparison of neurocognitive decline in older adults in same‐sex and opposite‐sex relationships
Author(s) -
Manca Riccardo,
Venneri Annalena
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.038598
Subject(s) - neurocognitive , mood , psychology , affect (linguistics) , population , cognitive decline , disease , clinical psychology , cognition , gerontology , medicine , dementia , psychiatry , environmental health , communication
Abstract Background Individuals from sexual minorities experience health inequalities that have a detrimental impact on both physical and mental health. This disadvantage may particularly affect ageing people by exacerbating symptoms of chronic conditions, such as Alzheimer’s disease (AD) and generating more complex care needs. However, neurocognitive functioning and impairments due to neurodegenerative diseases in the lesbian, gay and bisexual (LGB) ageing population remain under‐investigated. Race and mood problems may confer higher risk for subjective cognitive complaints, while being in a relationship may mitigate the risk of cognitive impairment in LGB older adults. Method Clinical data for this study were selected from the National Alzheimer’s Coordinating Center’s Uniform Data Set and structural MRI data included were collected in 14 Alzheimer’s Disease Research Centres. Twenty patients with AD and 20 healthy controls (HC) in same‐sex relationships were identified and matched to groups of participants (20 AD and 20 HC) in opposite‐sex relationship by sex, age, education, cognitive status, diagnosis and APOE status. Interactions between diagnosis and relationship on all measures were investigated. Additional post hoc analyses were carried out in the same‐sex and opposite‐sex groups separately. Result No diagnosis‐by‐relationship interactions were found on any variable, although patients in the same‐sex group were more likely to present with at least one neuropsychiatric symptom. The opposite‐sex group had grey matter atrophy mainly in medio‐temporal and insular areas, while in the same‐sex group it extended also in medial frontal and posterior cingulate areas. Conclusion Our preliminary findings suggest that neurocognitive decline due to AD may express similarly across individuals, independently of relationship type, thus further suggesting a possible role of relational status as a protective factor. However, the same‐sex group of patients, compared to HC, appeared to be more likely to experience at least one neuropsychiatric symptom and to have atrophy in fronto‐limbic and insular areas, in line with previous studies. Future investigations should clarify whether AD‐related symptoms may manifest differently in people from sexual minorities, along risk and protective factors, in order to inform prevention programs and treatment planning.