Department of Sociology, Michigan State University, East Lansing.
Department of Internal Medicine, Institute for Social Research and VA Center for Clinical Management Research, University of Michigan, Ann Arbor.
J Gerontol B Psychol Sci Soc Sci. 2021 Aug 13;76(7):1388-1399. doi: 10.1093/geronb/gbaa202.
We provide the first nationally representative population-based study of cognitive disparities among same-sex and different-sex couples in the United States.
We analyzed data from the Health and Retirement Study (2000-2016). The sample included 23,669 respondents (196 same-sex partners and 23,473 different-sex partners) aged 50 and older who contributed to 85,117 person-period records (496 from same-sex partners and 84,621 from different-sex partners). Cognitive impairment was assessed using the modified version of the Telephone Interview for Cognitive Status. Mixed-effects discrete-time hazard regression models were estimated to predict the odds of cognitive impairment.
The estimated odds of cognitive impairment were 78% (p < .01) higher for same-sex partners than for different-sex partners. This disparity was mainly explained by differences in marital status and, to a much lesser extent, by differences in physical and mental health. Specifically, a significantly higher proportion of same-sex partners than different-sex partners were cohabiting rather than legally married (72.98% vs. 5.42% in the study sample), and cohabitors had a significantly higher risk of cognitive impairment than their married counterparts (odds ratio = 1.53, p < .001).
The findings indicate that designing and implementing public policies and programs that work to eliminate societal homophobia, especially among older adults, is a critical step in reducing the elevated risk of cognitive impairment among older same-sex couples.
我们提供了第一项关于美国同性和异性伴侣认知差异的具有全国代表性的基于人群的研究。
我们分析了健康与退休研究（2000-2016 年）的数据。样本包括 23669 名年龄在 50 岁及以上的受访者（196 对同性伴侣和 23473 对异性伴侣），他们共贡献了 85117 个人时期记录（496 条来自同性伴侣，84621 条来自异性伴侣）。认知障碍使用电话访谈认知状态修改版进行评估。采用混合效应离散时间风险回归模型来预测认知障碍的几率。
同性伴侣发生认知障碍的几率比异性伴侣高 78%（p<.01）。这种差异主要归因于婚姻状况的差异，在较小程度上归因于身心健康的差异。具体来说，与异性伴侣相比，同性伴侣中有更高比例的人同居而非合法结婚（研究样本中分别为 72.98%和 5.42%），同居者发生认知障碍的风险明显高于已婚者（优势比=1.53，p<.001）。
研究结果表明，制定和实施旨在消除社会恐同现象的公共政策和计划，特别是针对老年人，是降低老年同性伴侣认知障碍风险的关键步骤。
