DOI: 10.1002/alz.079318 ISSN: 1552-5260

Chosen Family? Rethinking “Relationship Status” in LGB Cognitive Aging Research

Douglas William Hanes
  • Psychiatry and Mental health
  • Cellular and Molecular Neuroscience
  • Geriatrics and Gerontology
  • Neurology (clinical)
  • Developmental Neuroscience
  • Health Policy
  • Epidemiology



Existing studies have shown the importance of marital status and quality on later‐life cognitive health, including dementia risk and likelihood of timely dementia diagnosis. Yet, much evidence comes from different‐sex couples’ experiences, for whom marriage remains the norm and unmarried persons face social and material costs. In contrast, where same‐same marriage is legal in North America and Europe, marriage has not yet become the norm: same‐sex couples (SSCs) have lower marriage rates than different‐sex couples. SSCs also tend to structure their relationships differently across a range of domains, from household labor to sexual nonmonogamy. Throughout Europe and North America, older lesbian and gay people are also more likely to be single, to live alone, and to have no living children than straight or bisexual people; as a result, the former tend to rely less on partners or biological family to meet their social needs. Unlike straight men, for example, gay and bisexual men tend to rely less on their partners or daughters to forge and maintain social and community connections, instead relying on “chosen families”.


Given their unique prominence for sexual minorities, this paper uses population‐based surveys from the US (HRS) and Europe (ELSA and SHARE) to investigate measures of non‐biologically familial social bonds, including whether measures of friendship, social connectedness, and community involvement function similarly to marital status.


In the US, which has the highest marriage rates and a deeply entrenched “marriage culture”, LGB participants in the HRS (1998‐2018; n = 23,035) who indicate having never been married perform better cognitively at baseline than married LGB people (β = 1.5; p = 0.05), while never‐married straights perform worse (β = ‐0.9; p <0.01).


Relationship factors have a different association with cognitive health for LGB people than straight people, yet these remain unexplored in their effects on cognitive aging and queerer pathways to good cognitive health.

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