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LGBTQ Elders Are More Likely to Be Socially Isolated, Suffer from Dementia Than Straight Peers

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A new report by University of California San Francisco is making a big claim: LGBT people are at heightened risk of dementia. Additionally, LGBT elders are more likely to be socially isolated than their straight cisgender counterparts, and this social isolation can lead to more physical and mental health problems in comparison.

The new data was released at the 2019 Alzheimer’s Association International Conference (AAIC) in Los Angeles. Data was collected via mainly phone-based surveys across nine U.S. states. Approximately 44,000 adults aged 45 and older participated wherein roughly 3% of respondents identified themselves as a “sexual or gender minority.”

Another study presented at AAIC 2019 investigated the effectiveness of a first-of-its-kind Alzheimer’s intervention designed specifically to improve physical function and independence for LGBT older individuals with dementia and their caregivers.

The study, conducted by researchers at the University of Washington, showed the importance of tailored interventions and strong community partnerships in designing care for LGBT individuals.

“Much too little is known about Alzheimer’s disease and dementia in the LGBT community. In fact, the first data on the prevalence of dementia among sexual and gender minorities was reported only last year at AAIC 2018,” said Maria C. Carrillo, PhD, Alzheimer’s Association chief science officer.

“As expanding research efforts continue to teach us more about the variability of Alzheimer’s and other dementias — for example by sex, race, genetics and exposure to environmental factors — the Alzheimer’s Association will fund, and encourage others to fund, more studies in LGBT and other diverse populations,” Carrillo added.

Increased Risk for Subjective Cognitive Decline Among Sexual and Gender Minorities
Few studies have investigated the symptoms and disease progression of Alzheimer’s and other dementias in the LGBT community.

To examine these associations, Jason Flatt, PhD, MPH, assistant professor at the Institute for Health & Aging at the University of California, San Francisco, and colleagues analyzed data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS), a large phone-based survey led by the Centers for Disease Control and Prevention.

The study analyzed data from 44,403 adults aged 45 and older across nine states in the U.S. (Georgia, Hawaii, Illinois, Minnesota, Nevada, Ohio, Virginia, West Virginia, and Wisconsin) that participated in the 2015 BRFSS optional modules on the Healthy Brain Initiative, which included subjective cognitive decline and Sexual Orientation and Gender Identity.

Roughly three percent of participants (1,253) identified as a sexual or gender minority (SGM). Subjective cognitive decline was defined as self-reported confusion or memory problems that have been getting worse over the past year.

The researchers found that more than 14% of SGM participants reported subjective cognitive decline, significantly higher (p<0.0001) than the 10% rate among cisgender heterosexual participants. Even after adjusting for factors such as income, age and race, SGM participants were 29% more likely to report subjective cognitive decline.

More research is needed to understand why subjective cognitive decline may be higher in SGM individuals.

“Given that 1 in 7 adults who identified as a sexual or gender minority reported subjective cognitive decline, it is critical that more opportunities exist for people in these communities to receive regular evaluation for cognitive impairment and Alzheimer’s disease,” Flatt said. “There is also a need for greater education on Alzheimer’s risk, signs and symptoms, and training of health care providers to ensure inclusive and welcoming care for LGBTQ+ populations.”

“While we do not yet know for certain why sexual or gender minority individuals had higher subjective cognitive decline, we believe it may be due to higher rates of depression, inability to work, high stress, and a lack of regular access to healthcare,” Flatt added.

According to Flatt, less than half of SGM adults with SCD in the study talked to their health care provider about it. SGM adults with SCD were also more likely to report that they had to give up day-to-day activities (39% vs. 29%, p=0.003) and needed help with household tasks (44% vs. 35%, p=0.01) than cisgender heterosexual participants. Both groups were similar in terms of talking to their health care provider about their subjective cognitive decline.

First Study of an LGBT-Specific Alzheimer’s and Dementia Intervention
To advance research into Alzheimer’s in the LGBT community, Karen Fredriksen-Goldsen, PhD, professor and director of Healthy Generations Hartford Center of Excellence at the University of Washington, created the Aging with Pride: Innovations in Dementia Empowerment and Action (IDEA) study.

A multisite study in Seattle, San Francisco, and Los Angeles, Aging with Pride: IDEA is the first federally-funded study dementia intervention specifically designed for LGBT older adults with dementia and their caregivers.

The researchers had previously identified unique risk factors of LGBT older adults living with dementia through the first longitudinal study of this population (Aging with Pride: National Health, Aging, and Sexuality/Gender Study). Using longitudinal data with three time points (2014, 2015 and 2016), modifiable factors predicting physical functioning and quality of life (QOL) among LGBT older adults with dementia (n=646) were identified.

LGBT older adults living with dementia were significantly more likely to live alone (nearly 60%), not be partnered or married (65%), not have children (72%), and not have a caregiver (59%), when compared to older non-LGBT adults living with dementia. Previous experiences of discrimination and victimization (b=-0.19, p<.001) were negatively associated with QOL among LGBT older adults living with dementia. Socializing with friends or family (b=1.11, p<.05) was positively associated with QOL, and physical activity (b = 0.26, p<.001) were associated with better physical functioning.

As reported at AAIC 2019, Aging with Pride: IDEA includes a tailored approach in which trained coaches identify and modify challenging behaviors that are adversely affecting older adults living with dementia and their caregivers, either of whom are LGBT. The coaches delivered an individualized program of exercise, and behavioral and coping strategies designed to improve physical function, independence and QOL.

The exercise intervention is a low-impact physical exercise program including nine one-hour sessions over six weeks designed to improve physical functioning and maintain independence. The behavior and coping strategies include: techniques for working with LGBT-specific trauma, identity management and disclosure of their LGBT identities to providers and others, plus support engagement in the LGBT community and dementia services.

Testing of the intervention is now underway and will be delivered to 225 pairs of LGBT older adults living with dementia and their caregivers.

“Given their lifetime experiences of victimization, discrimination and bias, many LGBT older adults forgo seeking needed medical care,” said Fredriksen Goldsen. “LGBT people living with dementia and their caregivers often have difficulty accessing information and support services, which can be especially challenging when memory loss and dementia enter the equation.”

Image via GenPride.

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Top US Counter Intelligence Official Formally Announces Russia Working to Attack Biden, Helping Trump Win Re-Election

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The top counterintelligence official in the United States government has just released an official statement saying the Intelligence Community is actively working to help President Donald Trump get re-elected.

“We assess that Russia is using a range of measures to primarily denigrate former Vice President Biden and what it sees as an anti-Russia ‘establishment.’ This is consistent with Moscow’s public criticism of him when he was Vice President for his role in the Obama Administration’s policies on Ukraine and its support for the anti-Putin opposition inside Russia,” states National Counterintelligence and Security Center (NCSC) Director William Evanina.

“For example, pro-Russia Ukrainian parliamentarian Andriy Derkach is spreading claims about corruption – including through publicizing leaked phone calls – to undermine former Vice President Biden’s candidacy and the Democratic Party. Some Kremlin-linked actors are also seeking to boost President Trump’s candidacy on social media and Russian television.”

Evanina does not limit his assessment to Russia. China and Iran, he says, prefer Biden to win the election – which would account for Trump’s recent attacks on both countries, while refusing to challenge or confront Russian President Vladimir Putin on any issue.

“We assess that China prefers that President Trump – whom Beijing sees as unpredictable – does not win reelection. China has been expanding its influence efforts ahead of November 2020 to shape the policy environment in the United States, pressure political figures it views as opposed to China’s interests, and deflect and counter criticism of China.”

“We assess that Iran seeks to undermine U.S. democratic institutions, President Trump, and to divide the country in advance of the 2020 elections.”

U.S. Rep. Eric Swalwell (D-CA) says Senate Minority Leader Chuck Schumer, and other top Democrats, have been urging Evanina to release this information to the public.

But he warns that President Donald Trump is unlikely to act on it.

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Ohio GOP Governor Tests Positive for Coronavirus Just Before Meeting Trump

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Ohio Republican Governor Mike DeWine, 73, was scheduled to meet President Donald Trump on the tarmac but will not be there after testing positive for coronavirus. He reportedly has no symptoms.

DeWine refused to mandate masks until July 22.

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NRA Sued for Fraud and Self-Dealing by NY Attorney General – Calls for Top Gun Group to Be Dissolved

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The Attorney General of the State of New York announced Thursday she is suing the National Rifle Association for fraud, and calling for the organization to be dissolved, according to The Washington Post‘s Carol Leonnig.

“The chief executive of the National Rifle Association and several top lieutenants engaged in a decades-long pattern of fraud to raid the coffers of the powerful gun rights group for personal gain, according to a lawsuit filed Thursday by the New York attorney general, draining $64 million from the nonprofit in just three years,” The Post reports.

New York State Attorney General Letitia James “called for the dissolution of the NRA and the removal of CEO Wayne LaPierre from the leadership post he has held for the past 39 years, saying he and others used the group’s funds to finance a luxury lifestyle.”

The lawsuit claims NRA chief Wayne LaPierre recently arranged a $17 million golden parachute for himself and did not even seek board approval. It also details patterns of excessive spending, including  private jet travel, luxury vacation, and more than $1 million in reimbursements.

“LaPierre also spent $3.6 million of NRA money for private travel consultants to arrange private jets and executive car service for his and his family’s use over just two years, the suit says.”

UPDATE:

This is a breaking news and developing story. Details may change. This story will be updated, and NCRM will likely publish follow-up stories on this news. Stay tuned and refresh for updates.

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