# Alzheimer's disease and related dementias among transfeminine adults: A cohort study

## TL;DR

This study finds that transfeminine adults may have a higher risk of Alzheimer's disease and related dementias compared to cisgender individuals, especially those who received gender-affirming hormone therapy.

## Contribution

The paper provides one of the first prevalence estimates of Alzheimer's disease and related dementias among transfeminine adults with a history of gender-affirming hormone therapy.

## Key findings

- Transfeminine adults had higher odds of Alzheimer's disease and related dementias compared to cisgender men and women.
- Those with a history of gender-affirming hormone therapy showed even higher odds of ADRD.
- Adjusting for enrollment time reduced the significance of these associations.

## Abstract

We investigated whether Alzheimer's disease and related dementias (ADRD) are more common among transfeminine (TF) adults than among demographically similar cisgender people enrolled in the same health system.

We analyzed electronic health records of 856 TF adults aged 65+ and matched cisgender men (CM) and cisgender women (CW) and compared ADRD prevalence across groups by calculating enrollment‐adjusted odds ratios (aOR) and 95% confidence intervals (CI).

The aOR of ADRD among TF adults were 1.39 (95% CI: 0.99–1.97) relative to CM and 1.29 (95% CI: 0.92–1.82) relative to CW referents. For TF adults with evidence of receiving gender‐affirming hormone therapy (GAHT) receipt, the associations were slightly stronger: 1.75 (1.13–2.69) and 1.70 (1.11–2.60). Results restricted to minoritized ethnoracial groups appeared smaller, but imprecise.

These findings suggest that ADRD diagnosis and management may represent a priority in the healthcare of older TF people, particularly those with a history of GAHT.

One of the first prevalence estimates of Alzheimer's disease and related dementias (ADRD) among transfeminine (TF) adults with a history of gender‐affirming hormone therapy receipt (GAHT).TF adults had a significantly higher prevalence of ADRD compared to their matched cisgender men and cisgender women referents.After adjusting for enrollment time, the associations were no longer significant.TF adults with a history of GAHT had higher ADRD odds than cisgender referents.Future incidence studies may help disentangle the effects of GAHT from other factors influencing ADRD risk.

One of the first prevalence estimates of Alzheimer's disease and related dementias (ADRD) among transfeminine (TF) adults with a history of gender‐affirming hormone therapy receipt (GAHT).

TF adults had a significantly higher prevalence of ADRD compared to their matched cisgender men and cisgender women referents.

After adjusting for enrollment time, the associations were no longer significant.

TF adults with a history of GAHT had higher ADRD odds than cisgender referents.

Future incidence studies may help disentangle the effects of GAHT from other factors influencing ADRD risk.