A recent publication in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association unveils significant differences in Alzheimer’s disease risk factors among transgender men, transgender women, and non-binary individuals
This groundbreaking study, the first of its kind, examines variations in dementia risk across lifespans based on sex and gender identity.
Alzheimer’s disease risk factors encompass a range of lifestyle, environmental, and genetic elements that contribute to the likelihood of developing the condition. While some factors like age, genetics and family history remain fixed, others such as diet, physical activity, diabetes, blood pressure and depression can be modified to mitigate risk.
Dr Brooke Brady, lead author of the study and interdisciplinary research fellow at the School of Psychology and Ageing Futures Institute at UNSW Sydney, emphasises the importance of addressing gender diversity within health research and policy.
“We’ve made good progress in documenting the experiences of some traditionally marginalised groups based on other characteristics, but we’re yet to do that for transgender and gender diverse people, who have been long overlooked in health research and policy.”
The study underscores the distinction between sex and gender identity, noting that while related, they remain distinct concepts. Sex pertains to biological attributes like male, female, or other variations, whereas gender is a dynamic construct influenced by psychological, social, and cultural factors.
The research found that while males exhibit higher Alzheimer’s risk in midlife, this trend reverses in old age when females report elevated risk. These disparities are influenced by a range of modifiable risk factors unique to transgender and gender-diverse individuals.
Comparing risk factor prevalence between 955 transgender or gender-diverse participants and age-matched cisgender adults, the study employed the ANU Alzheimer’s Disease Risk Index to evaluate dementia risk. Transgender men, transgender women, and non-binary adults displayed higher overall late-life Alzheimer’s disease risk compared to cisgender counterparts.
A number of specific modifiable risk factors contribute to this increased risk, including elevated rates of depression among non-binary adults, higher instances of kidney problems, and increased heart attack rates in transgender and non-binary individuals.
Dr Brady emphasises the potential for interventions targeting these risk factors to delay or prevent dementia cases within the transgender and non-binary community. Addressing social stigma, discrimination, and healthcare access barriers may also play a crucial role in reducing these disparities and improving overall health and well-being.
Further research is crucial to gathering comprehensive data and expanding the evidence base, ultimately working towards reducing health disparities and enhancing dementia risk understanding within transgender and gender-diverse populations.
“We would also love to understand how this compares to dementia risk in Australia and other countries, but we need to develop strong local and global datasets. In doing so, I hope we can dramatically grow the evidence base and dramatically shrink the health disparities impacting trans and non-binary adults in dementia risk,” Dr Brady said.