主观认知衰退与跨性别和非二元性别老年群体在医疗环境中受到歧视有关。
Subjective Cognitive Decline Associated with Discrimination in Medical Settings among Transgender and Nonbinary Older Adults.
机构信息
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.
出版信息
Int J Environ Res Public Health. 2022 Jul 27;19(15):9168. doi: 10.3390/ijerph19159168.
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 ( = 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; = 0.006), and 7.5 times more likely to report poor/fair memory (OR: 7.49; 95%-CI: 1.7-32.8; = 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.
背景
跨性别和非二元性别（TNB）个体比非 TNB 个体报告更大的主观认知下降（SCD）。SCD 涉及自我报告的记忆和思维问题，是阿尔茨海默病和相关痴呆症（ADRD）的潜在风险。我们在 TNB 老年样本中探讨了与 SCD 相关的社会心理因素，如医疗环境中的歧视。
方法
我们利用了包括 TNB 成年人在内的年龄健康、SCD（过去一年记忆问题和记忆恶化）和医疗环境中歧视的 PRIDE 研究的横断面数据（ = 115）。使用多变量逻辑回归检验关联。
结果
近 16%的 TNB 参与者将他们的记忆评为差/一般，17%的参与者报告他们的记忆比一年前更差。有 SCD 的 TNB 老年成年人更有可能报告在医疗环境中受到歧视。调整后，报告在医疗环境中受到歧视的人报告记忆恶化的可能性是未报告歧视的人的 4.5 倍（OR：4.5；95%CI：1.5-13.2； = 0.006），报告记忆差/一般的可能性是未报告歧视的人的 7.5 倍（OR：7.49；95%CI：1.7-32.8； = 0.008）。结论：TNB 老年成年人报告了 SCD 和医疗环境中歧视的高频率。需要进一步研究探索肯定性认知筛查和医疗保健服务。
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