Risk of impairment in cognitive instrumental activities of daily living for sexual and gender minority adults with reported Parkinson’s disease

Abstract

Objective: To investigate the risk of impairment in cognitive instrumental activities of daily living (IADL) for people with Parkinson’s (PwP) identifying as sexual and/or gender minorities (SGM). Method: Data were obtained from Fox Insight, an online, longitudinal study with self/informant-report questionnaires from PwP and people without Parkinson’s. Groups consisted of PwP without cognitive IADL impairment at baseline, identifying as (1) SGM with female sex assigned at birth (SGM-F, n = 75); (2) cisgender, heterosexual with female sex assigned at birth (CH-F, n = 2046); (3) SGM with male sex assigned at birth (SGM-M, n = 84); (4) cisgender, heterosexual with male sex assigned at birth (CH-M, n = 2056). Impairment in cognitive IADL was based on Penn Parkinson’s Daily Activities Questionnaire-15 (PDAQ-15). Group differences for PDAQ-15 and impairment likelihood during follow-up were assessed with unadjusted models and adjusting for variables that differed between the groups. Results: SGM-F were the youngest at Parkinson’s diagnosis; SGM-M had the lowest PDAQ-15 at baseline (p ≤ .014 for all). Scores declined more for males than females in unadjusted and adjusted models (p < .001 for both). In unadjusted models, SGM-M had a higher impairment risk than PwP identifying as cisgender and heterosexual (p ≤ .018). In adjusted models, females had a lower impairment risk than males (p < .001). Age, education, and discrimination level were significant moderators (p < .001 for all). Conclusions: SGM-M can be at a higher risk for impairment in cognitive IADL, associated with social determinants. Female sex assigned at birth may be associated with a lower level of impairment risk, although this advantage can disappear with social determinants.

Keywords:

• Parkinson’s disease
• instrumental activities of daily living
• sexual and gender minorities
• LGBTQIA+
• sexual orientation and gender identity

Acknowledgments

Data used in the preparation of this article were obtained from the Fox Insight database (https://foxinsight-info.michaeljfox.org/insight/explore/insight.jsp) on 5 April 2023. For up-to-date information on the study, visit https://foxinsight-info.michaeljfox.org/insight/explore/insight.jsp.

We would like to thank the Parkinson’s community for participating in this study to make this research possible.

The funding agencies did not play an active role in the design, conduct, and submission of this research. The views and opinions expressed in this publication represent those of the authors and do not necessarily reflect the official views of the funding agencies.

Disclosure statement

The authors report there are no competing interests to declare.

Data availability statement

Data used in the preparation of this article are accessible to researchers through the Fox Insight Data Repository upon agreeing to and signing the Data Use Agreement(s). For up-to-date information, please visit https://foxinsight-info.michaeljfox.org/insight/explore/insight.jsp.

Additional information

Funding

Data were obtained from the Fox Insight study funded by The Michael J. Fox Foundation for Parkinson’s Research. EB is supported by the National Institute on Aging (K99AG073453) and the Lewy Body Dementia Association, and SJB is supported by the National Institute on Aging (1R01AG066088).