Abstract Details

Title Brain Health Outcomes in Sexual and Gender Minority Groups

Topic Health Care Disparities

Presentation(s) S14 - Health Care Disparities (11:27 AM-11:39 AM)

Poster/Presentation
Number 002

Background

Mounting evidence shows that SGM groups experience health disparities, but research on brain health status of this underrepresented group is very limited.

Objective

We evaluated whether sexual and gender minority (SGM) persons are at higher risk of adverse brain health outcomes compared to cisgender heterosexual (non-SGM) individuals.

Design/Methods

We conducted a cross-sectional study in the All of Us Research Program, a population study focused on health disparities enrolling 1 million Americans. We used baseline questionnaires to identify participants from sexual minorities (non-straight e.g., gay, lesbian, bisexual) and gender minorities (gender identity different from sex assigned at birth). We further divided gender minorities into gender diverse (e.g., non-binary) and transgender. The primary outcome was a composite of stroke, dementia, and late-life depression. Secondarily, we evaluated SGM subgroups and diseases separately. We used multivariable logistic regression (adjusted to age, ethnicity, cardiovascular risk factors, social status) to assess the relationship between SGM groups and brain health outcomes.

Results

We included 393,041 participants (mean age 51, female sex at birth 62%), of whom 39,632 (10%) belonged to SGM groups. Of these, 4,431 (1%) belonged to a gender minority (2,212 [50%] gender diverse, 2,219 [50%] transgender) and 38,528 (10%) to a sexual minority. Compared to non-SGM, SGM individuals had 19% higher odds of the brain health composite outcome (OR 1.19, 95%CI 1.13-1.25). These results persisted across all SGM subgroups (p<0.05). Assessing individual diseases, all SGM groups had higher odds of late-life depression (SGM vs. non-SGM: 1.26, 1.17-1.34), all SGM except transgender persons had higher odds of dementia (SGM vs. non-SGM: 1.27, 1.15-1.39), and gender minority groups had higher odds of stroke (1.32, 1.03-1.61).

Conclusions

In a large US population study, SGM individuals had higher odds of adverse brain health outcomes. Further research should explore structural causes of inequity to advance inclusive and diverse neurological care.

Authors/Disclosures
Shufan Huo, MD, PhD (Yale University) PRESENTER	Dr. Huo has nothing to disclose.
Cyprien Rivier, MD (Yale University)	Dr. Rivier has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Pyxis Partners.
Santiago Clocchiatti-Tuozzo (Yale University, Department of Neurology)	Mr. Clocchiatti-Tuozzo has nothing to disclose.
Daniela B. Renedo, MD (Yale University)	Dr. Renedo has nothing to disclose.
N. Abimbola Sunmonu, MD, PhD (Yale Neurology)	Dr. Sunmonu has nothing to disclose.
Adam De Havenon, MD, FAAN (Yale University)	Dr. De Havenon has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novo Nordisk. Dr. De Havenon has stock in Certus. Dr. De Havenon has stock in TitinKM. The institution of Dr. De Havenon has received research support from NIH/NINDS. Dr. De Havenon has received publishing royalties from a publication relating to health care.
Kevin N. Sheth, MD, FAAN (Yale UniversityDivision of Neuro and Critical Care)	Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Zoll. Dr. Sheth has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NControl. Dr. Sheth has received stock or an ownership interest from Astrocyte. Dr. Sheth has received stock or an ownership interest from Alva. The institution of Dr. Sheth has received research support from Biogen. The institution of Dr. Sheth has received research support from Novartis. The institution of Dr. Sheth has received research support from Bard. The institution of Dr. Sheth has received research support from Hyperfine. Dr. Sheth has received intellectual property interests from a discovery or technology relating to health care.
Guido J. Falcone, MD (Yale School of Medicine)	The institution of Dr. Falcone has received research support from NIH. The institution of Dr. Falcone has received research support from AHA.