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Transgender and non-binary adults may be at higher risk of developing Alzheimer’s disease – the most common form of dementia – in later life, due to key risk factors being more prevalent in this population.

Research recently published in shows some risk factors for Alzheimer’s disease are disproportionately higher in transgender men, transgender women, and non-binary populations. It is the first global study to investigate differences in dementia risk according to sex and gender identity across the lifespan.

Risk factors are aspects of lifestyle, environment and genetics that increase the likelihood of getting a disease. While risk factors do not necessarily cause disease, they can increase the chances of developing it.

Some risk factors for Alzheimer’s disease, like age, genetics, and family history, cannot be changed. However, others can be modified to help reduce the risk of dementia, such as diet, physical activity, diabetes, blood pressure and depression.

“We’ve made good progress in documenting the experiences of some traditionally marginalised groups based on other characteristics, but we’re yet to do that for transgender and gender diverse people, who have been long overlooked in health research and policy,” says Dr Brooke Brady, lead author of the study and interdisciplinary research fellow at the School of Psychology and Ageing Futures Institute at ���������¼� Sydney.

“When it comes to dementia and Alzheimer’s disease risk, it appears there are some modifiable risk factors impacting transgender and gender-diverse people that may not have been considered.”

While sex and gender are interrelated and often used interchangeably, they are different concepts. Sex refers to biological status as male, female, or another variation of sex characteristics. Gender is a dynamic social construct that includes psychological, social, and cultural factors around attitudes, behaviours, and stereotypes.

For cisgender individuals, sex and gender identity generally match prevailing norms. For individuals who are transgender or non-binary (sometimes called gender-diverse), their experience of gender may not match the norms associated with their sex assigned at birth. 

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“It’s vital we’re considering sex differences separately from gender differences because, as the findings of this study illustrate, they may have a different relationship to dementia and Alzheimer’s disease risk across the lifespan,” Dr Brady says.

The study also found that the level of risk changes over the life course, according to sex assigned at birth. While males had higher overall risk in middle-age, this pattern reversed in old age when females reported higher overall risk.