Data shows SCD is more prevalent in those who are transgender.
Research presented at the Alzheimer’s Association International Conference (AAIC) 2021 shows transgender adults are twice as likely to have early onset subjective cognitive decline (SCD) than those who are cisgender. They are also twice as likely to have SCD that affects their ability to engage in daily tasks such as social interactions and going to work. SCD is self-reported problems with memory and is one of the first clinical signs of Alzheimer’s disease and dementia (ADRD).
“Trans populations are disproportionately impacted by health disparities and also risk factors for dementia. Putting these pieces together, I wasn’t surprised by their greater risk of cognitive decline,” said study investigator Ethan Cicero, PhD, RN, with Emory University Nell Hodgson Woodruff School of Nursing in Atlanta, Georgia.
A study reviewing medical outcomes in the ten-year span between 2005 and 2015 previously found transgender individuals who had received a diagnosis of gender incongruence were “six times more likely to have a mood or anxiety disorder than the general population; three times as likely to be prescribed antidepressants and antianxiety medications; more than six times as likely to attempt suicide resulting in hospitalization.” Another showed, “Prevalence of depression was higher for transgender and gender nonbinary adults (individuals who identify outside the male/female binary) (37%) compared to cisgender adults (19.2%).”
The AAIC 2021 presentation shared the results of a sample that included 386,529 adults of whom 1302 identified as transgender and 385,227 as cisgender. “Roughly 17% of transgender adults reported SCD, which is significantly higher than the 10.6% rate for cisgender adults (P < .001),” the findings show. Gender-affirming surgery can ease some of the mental health concerns experienced by this population, but this is not always an easily accessible option.
SCD has a high correlation with both depression anxiety, in general, with data revealing these “constructs may potentially be useful to identify high-risk populations for preventive interventions and trials.” A previous study, conducted in 2018, also compared depression with cognitive impairment and decline. This study showed, “Depression and functional impairment should be considered when screening LGBT older adults for cognitive impairment and dementia. Future research on the cognitive impairment and dementia risk in LGBT older adults is needed.”
Anxiety and depression are more prevalent in transgender individuals than their cisgender peers. Subjective cognitive decline can correlate with underlying mental health disorders, which leads these individuals to be more susceptible to dementia and other issues related to cognitive decline. Thus, the factors are interrelated and, when taken together, leave the population at high risk.
Moreover, the results of these studies are representative of a public health issue that needs to be addressed, and more resources and support for transgender mental health is needed. Intervening and managing mental health symptoms may slow cognitive decline and lead to a higher quality of life later on.