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Accessing healthcare is complicated for many people, but LGBTQ+ older adults face a specific set of concerns and challenges. For example, according to SAGE’s new report, Out & Visible, 40% of LGBTQ+ people in their 60’s and 70’s say their healthcare providers don’t know their sexual orientations—which can lead to poorer health outcomes.

SAGE and Pfizer recently collaborated to help improve the health of LGBTQ+ older people with a series of “Lunch and Learn” events. Our most recent event featured Matt Kudish of the New York City Chapter of the Alzheimer’s Association. Read the interview and check out our fact sheet to learn more!

Thanks for taking the time to help educate SAGE participants, Matt! It seems like there are some serious misconceptions about dementia and Alzheimer’s disease. Can you help clarify the difference between the two, for starters? 

Dementia is actually not a disease. Dementia is an umbrella term that talks about a group of symptoms. It’s a term used to describe a state of mind where a person is experiencing changes in their memory, thinking, behavior and physical functioning. There are approximately 100 causes of dementia.  Alzheimer’s disease is one cause of dementia. Alzheimer’s disease is a progressive, degenerative disease of the brain that causes brain cells to die. The death of the brain cells it what causes the dementia. So the two are clearly related, but they’re not at all the same thing. If someone has Alzheimer’s disease, they are experiencing dementia. But if someone is experiencing dementia, the cause may be Alzheimer’s or it could be roughly 99 other things.

At what age do we begin to see more instances of dementia and Alzheimer’s? Or does the onset of these conditions usually happen at different ages?

The greatest risk factor for developing Alzheimer’s is aging, so as we age our risk increases. Today, it is estimated that 1 out of every 9 people over the age of 65 is living with Alzheimer. For every decade after 65 the prevalence doubles, so that when we talk about people 85 and over, we’re talking about 1 out of every 3 people living with Alzheimer’s. Those figures, however, can lead people to think that Alzheimer’s disease is just what happens as we get older.  That could not be further from the truth.   Yes, the disease tends to affect older adults more than younger adults, but Alzheimer’s is a disease.  It is not normal aging. If one out of three over the age of 85 have Alzheimer’s, 2 out of 3 do not.

There are cases of younger-onset Alzheimer’s, which is when the disease affects someone younger than 65. In some very rare cases the cause is genetics, but genetic Alzheimer’s represents only about 1% of people with the disease. It is extremely rare.

How are LGBTQ+ people impacted by, or more vulnerable to, these diseases in particular? Is there a gender disparity in instances of these disease?

In terms of prevalence, being LGBTQ+ has no bearing on risk. Frankly, everyone is at risk. If you have a brain, you’re at risk for developing Alzheimer’s disease.

We do see more women with the disease than men.   We believe this is largely because women live longer than men.

There are some ethnic groups that are at an increased risk of developing Alzheimer’s. African Americans and Latinos are twice as likely and one and a half times as likely, respectively, than Caucasians to develop the disease. We believe this is due to the increased risk among these groups of other health issues such as diabetes and hypertension, which also increase ones risk for Alzheimer’s. It’s important to realize, though, that an increase in risk is not deterministic, meaning that just because your risk is increased does not mean you will develop the disease.

What are some simple, more manageable preventative measures you might recommend?

Much more research needs to take place in the area of prevention. Currently there is nothing we can do that will, with certainty, prevent the disease. There are things, however, that can reduce one’s risk. Heart health is brain health. Anything that is good for the heart is also good for the brain, we should exercise, eat right, and not smoke. It’s also important that we keep our brains active and engaged, and challenge ourselves to learn new things. And I mean really challenge yourself! If you speak three languages, don’t learn a fourth. Maybe you’ll want to learn to play an instrument. Challenging our brains allows new pathways for information to be created which can be helpful.

Are there any exciting new treatments or findings about these diseases that we should be aware of?

This is an enormous area of research right now, both in the US and across the world. There are many potentially exciting things being looked at.

The diagnostics have evolved significantly over the last few years, and that’s very helpful to the research. Scientists are now starting to look at pre-symptomatic individuals who are likely to develop the disease and exploring what, if any, existing interventions may play a preventive role.  We are learning more and more every day about the disease, and its underlying cause.

It’s important that we become good consumers of information. Be discerning with what you hear and read about foods and supplements. Make sure that the evidence supports your choices so that you are making informed choices. There’s a lot of misinformation among the good information and it’s important that we pay attention to make sure we know the difference.

— Posted by Kira Garcia