Manca Riccardo, Venneri Annalena
Department of Life Sciences, Brunel University London, Uxbridge, UK.
Department of Medicine and Surgery, University of Parma, Parma, Italy.
Innov Aging. 2023 Sep 24;7(8):igad110. doi: 10.1093/geroni/igad110. eCollection 2023.
Sexual minorities experience health inequalities, but little is known about differences in neurocognitive health between heterosexual and sexual minority older adults and potential risk factors. To investigate minority stress, depression, and marital status as risk factors for worse cognitive performance in sexual minority older adults.
A total of 336 sexual minorities and 5,561 heterosexual participants aged 50+, noninstitutionalized, and free from neurodegenerative diseases from Wave 6 of the English Longitudinal Study of Ageing were included. Cognitive performance (i.e., temporal orientation, episodic memory, and fluid intelligence) of sexual minority and heterosexual older adults was compared using general linear models including age, sex, and education as covariates. The differential impact of minority stress, depressive symptoms, and marital status on cognition in the 2 groups were also tested. Analyses were weighted for sampling probability and differential nonresponse.
Sexual minority participants were more likely to report minority stress and to be single but had better episodic memory than heterosexual participants. Depression and being single were associated with worse cognitive performance in both groups. However, minority stress was negatively associated ( = -2.116, = .016) with fluid intelligence in the sexual minority group only.
Better memory in sexual minority participants and a negative effect of risk factors on cognition are in line with previous studies. However, this study provides the first evidence of a potential negative impact of minority stress on cognitive performance in sexual minorities. Further investigations are needed to assess minority stress more in detail and clarify its potential mechanisms of action on cognition in sexual minorities.
性少数群体存在健康不平等现象，但对于异性恋和性少数老年成年人在神经认知健康方面的差异以及潜在风险因素，我们知之甚少。本研究旨在调查少数群体压力、抑郁和婚姻状况作为性少数老年成年人认知功能较差的风险因素。
纳入了来自英国老龄化纵向研究第6波的336名性少数群体和5561名50岁以上、非机构化且无神经退行性疾病的异性恋参与者。使用包括年龄、性别和教育程度作为协变量的一般线性模型，比较了性少数群体和异性恋老年成年人的认知表现（即时间定向、情景记忆和流体智力）。还测试了少数群体压力、抑郁症状和婚姻状况对两组认知的不同影响。分析对抽样概率和差异无应答进行了加权。
性少数群体参与者更有可能报告少数群体压力且单身，但情景记忆比异性恋参与者更好。抑郁和单身在两组中均与较差的认知表现相关。然而，仅在性少数群体中，少数群体压力与流体智力呈负相关（β = -2.116，P = .016）。
性少数群体参与者更好的记忆力以及风险因素对认知的负面影响与先前的研究一致。然而，本研究首次提供了少数群体压力对性少数群体认知表现潜在负面影响的证据。需要进一步调查以更详细地评估少数群体压力，并阐明其对性少数群体认知的潜在作用机制。
