A new study published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association has found transgender and non-binary adults may be at higher risk of developing Alzheimer’s disease in later life. 

The study, which was led by Dr. Brooke Brady of UNSW Sydney, compared the prevalence of modifiable risk factors for dementia in 955 transgender or gender-diverse participants and a sample of age-matched cisgender adults in the United States. 

The researchers found transgender men, transgender women, and non-binary adults all had higher overall late-life Alzheimer’s disease risk compared to cisgender men and cisgender women. 

A number of significant differences in specific modifiable risk factors may have contributed to this result. For example, the researchers found: 

• Non-binary adults had the highest rates of depression (49.8%), significantly higher compared to cisgender men (13.8%), cisgender women (23.6%), and transgender women (30.7%)  
• Transgender men showed the second highest rates of depression (39.8%), significantly higher than both cisgender men and cisgender women 
• Higher rates of kidney problems among non-binary adults (8%) compared to cisgender men (0.9%) and cisgender women (1.3%). Kidney disease and dementia share some risk factors, and those diagnosed with kidney disease may have a moderately increased rate of dementia. 
• Non-binary adults also showed the highest rates of physical inactivity (35.6%) compared to both cisgender men (23.2%) and women (23.9%)  

Dr Brady indicated that these modifiable risk factors may be driving the higher risk of later-life Alzheimer’s disease for this cohort. 

“These disparities in modifiable risk factors like higher rates of depression and kidney disorders are significant… [b]ut if we can address and change those risk factors, we may help to delay or prevent some dementia cases among this under-served and underrepresented group,” Dr Brady said. 

Other factors may also have a significant and disproportionate impact on dementia risk for transgender and gender-diverse populations but weren’t measurable from the data. For example, social isolation may be more prevalent among transgender and gender-diverse groups, caused at least in part by social stigma and discrimination. 

“Previous research has reported that some transgender and gender-diverse older people experience more limited social support compared to other groups. Additionally, transgender and gender-diverse older adults often face obstacles in accessing health care and support when they need it,” Dr. Brady said. 

“We think tackling social stigma and discrimination could go a long way in normalising transgender and gender-diverse lived experiences and correct some of the health inequalities we see not only in the case of Alzheimer’s disease risk, but for many other aspects of health and wellbeing.” 

Dr. Brady says research is needed to collect data that includes transgender and gender-diverse people to understand the needs of these under-served 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,” Dr. Brady said.  

“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.”