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

Abstract<bold>Objective:</bold> 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). <bold>Method:</bold> 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, <italic>n</italic> = 75); (2) cisgender, heterosexual with female sex assigned at birth (CH-F, <italic>n</italic> = 2046); (3) SGM with male sex assigned at birth (SGM-M, <italic>n</italic> = 84); (4) cisgender, heterosexual with male sex assigned at birth (CH-M, <italic>n</italic> = 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. <bold>Results:</bold> SGM-F were the youngest at Parkinson’s diagnosis; SGM-M had the lowest PDAQ-15 at baseline (<italic>p</italic> ≤ .014 for all). Scores declined more for males than females in unadjusted and adjusted models (<italic>p</italic> < .001 for both). In unadjusted models, SGM-M had a higher impairment risk than PwP identifying as cisgender and heterosexual (<italic>p</italic> ≤ .018). In adjusted models, females had a lower impairment risk than males (<italic>p</italic> < .001). Age, education, and discrimination level were significant moderators (<italic>p</italic> < .001 for all). <bold>Conclusions:</bold> 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. [ABSTRACT FROM AUTHOR]