Associations Between Cognitive Risk Scores and Objective Cognition by Sexual Orientation: Evidence From the CLSA

This study investigated differences in cognitive risk and objective cognitive performance between lesbian, gay, and bisexual (LGB; <i>n</i> = 309) and heterosexual (<i>n</i> = 16,207) older adults using baseline data (2011-2015) from the Comprehensive cohort of the Canadian Longitudinal Study on Aging (CLSA). Cognitive risk was assessed using the Australian National University - Alzheimer's Disease Risk Index (ANU-ADRI). Cognitive performance was measured using a composite score based on performance on six cognitive tests. The analytic strategy included a combination of t-tests, chi-square tests, and linear regression models. Contrary to expectations, LGB participants exhibited lower cognitive risk scores (M = -1.08, SD = 8.85) in comparison to heterosexual participants (M = 0.61, SD = 10.62). On subcomponents of the ANU-ADRI score, LGB participants reported higher rates of depression and smoking, and lower social engagement. In terms of cognitive performance, LGB participants scored significantly higher (M = 104.58, SD = 14.72) in comparison to heterosexual participants (M = 100.12, SD = 15.05). This difference remained even after controlling for ANU-ADRI score, race, and income. Our findings highlight the importance of incorporating sociodemographic characteristics into cognitive risk assessments.