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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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Ivanka’s Investment Advice Became a ‘Rotten Deal’ That Has the Trump Kids Hoping for a Bailout: Report

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According to a report from Forbes’ Dan Alexander, the children of Donald Trump are hoping that the sale of the lease of the Trump International Hotel in Washington DC, for a reported $400 million goes through because it will bail them out of a “rotten investment” first proposed by Ivanka.

Earlier in the week the Wall Street Journal reported that the lease for Trump International — which has been nothing but a money-loser for the family — might be purchased by a Miami-based investment firm known as CGI Merchant Group.

The Journal reported the lease could be going for a reported $400 million — a drop from the $500 million that was being sought two years before.

As Alexander points out there is some skepticism about that amount which could have a major bearing on how much money each of the Trump kids, Don Jr, Eric and Ivanka walk away with — and for that they can thank Ivanka.

The Forbes writer explained that the Trump International is an anomaly among Trump properties and that the suggestion the family make the investment years ago originated with Ivanka.

“For a 75-year-old billionaire, Donald Trump doesn’t seem to have passed down much of his fortune to his children … A review of documents suggests that in the Trump family, however, the heirs don’t hold ownership stakes in any of their father’s major assets, except one: The Trump International Hotel in Washington, D.C.,” the Forbes editor wrote. “The three eldest Trump children—Don Jr., Eric and Ivanka—all seem to have 7.5% interests in a lease on the property. Unfortunately for them, the asset has been performing poorly, losing so much money that one of Donald Trump’s holding companies has had to inject additional cash to prop up the business, according to an analysis of financial statements that the House Committee on Oversight and Reform released last week.”

According to Alexander, Ivanka made the investment suggestion while “Don Jr. worked on leasing retail spaces, and Eric helped look after the operation, but things did not go well,” adding, “Deutsche Bank provided $170 million of financing, and by August 31, 2017, the Trump Organization’s financial statements listed $193 million for building improvements, $18 million for furniture and equipment, $5 million for operating supplies and $100,000 for tenant improvements, according to the House documents. Total tally: $216 million.”

That total, the Forbes editor is key when it comes to understanding what a “rotten investment” it became.

Pointing out that the “Trump family had invested an estimated $240 million—$170 million of which came from Deutsche Bank and $70 million that seems to have come straight from the family’s pockets,” Alexander wrote. “Bad news, given that plenty of people don’t think the place is worth $240 million. After speaking with seven real estate experts, Forbes estimated last month that the property was worth $173 million. Assuming the Trumps haven’t paid any of the principal back on their loan, that means their equity amounts to just $3 million, $67 million less than the amount of cash the family apparently invested into the place before August 2020.”

That difference, he points out, means the Trump kids could walk away with little for their years of efforts — or they could be the recipients of a massive bailout.

“Some industry insiders questioned the credibility of that report, given the sky-high price. But if such a sale actually goes through, all of the financial problems that the hotel has caused for the Trumps would suddenly wash away,” he wrote. “The kids’ apparent 7.5% interests—which would be worth just $225,000 after debt at a $173 million valuation—would grow to an estimated $15 million apiece. That’s a lot of money for Eric and Don Jr., who Forbes estimated were each worth $25 million in 2019. It’s also a fair chunk of change for Ivanka, who shares a fortune estimated at $375 million with her husband, Jared Kushner, heir to a separate real estate dynasty.”

You can read more here.

 

Image by Gage Skidmore via Flickr and a CC license

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‘It’s Quite Glaring’: Top Lawyers Won’t Touch Trump With a ‘1000-Foot Pole’ as Legal Crises Escalate

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Donald Trump is facing intensifying legal pressure, but he’s been unable to attract the type of high-quality lawyers that would typically represent a former president in high-stakes cases.

At least four well-known attorneys have turned down repeated entreaties by Trump’s team in recent weeks, a source familiar with the discussions told CNN, leaving the twice-impeached one-term president with a small and relatively inexperienced legal team to litigate executive privilege and other constitutional issues.

“You’d want to see a top 10 national law firm with a big, experienced DC office,” said John Yoo, a University of California at Berkeley law professor and former Justice Department official for George W. Bush. “You don’t see that here. It’s quite glaring.”

Some big-name attorneys have been scared away by the ex-president’s reputation for non-payment of legal fees, according to sources close to conservative legal circles, while others are staying away because of the damage Trump’s previous lawyers have suffered to their reputations.

“It’s not a 10-foot pole,” Yoo said, “it’s a 1,000-foot pole.”

One attorney who turned Trump down is white-collar lawyer William Burck, who represented 11 Trump associates in the Robert Mueller investigation but turned down the former president three times in recent months because he had become too toxic after trying to overturn his election loss.

“I don’t even know who they are, they are just looking to get publicity,” Trump insisted in a statement. “I am using lawyers who have been with us from the beginning.”

Two former legal advisers, Patrick Philbin from the White House counsel’s office and Justin Clark from the 2020 campaign, are still involved in Trump’s legal affairs, but they might find it difficult to get paid if the former president doesn’t like the outcome in his fight over executive privilege.

“I do pay my lawyers when they do a good job,” Trump said.

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Cops Remove ‘Disorderly’ GOP US Senate Candidate Josh Mandel From School Board Meeting: Report

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Trump-loving Ohio GOP Senate candidate Josh Mandel was removed from a Butler County school board meeting after he got up and berated the board over its policies on masks and transgender students.

The Cincinnati Enquirer reports that Mandel was invited to the meeting by school board candidate Darbi Boddy, who said she wanted him to speak on her behalf even though he didn’t even live in the district.

Although the board does allow nonresidents to address the board if a resident introduces them as their designee, Boddy apparently failed to follow proper protocols, which led the school board to ask Mandel to stop speaking.

Mandel, however, refused and continued to attack the board for forcing children to wear masks in schools during the COVID-19 pandemic.

At this point, two Butler County Sheriff’s officers escorted Mandel out of the meeting, and the Enquirer notes that board members may ask for assistance from law enforcement officials when “a disorderly person when that person’s conduct interferes with the orderly progress of the meeting.”

In an interview with the Enquirer, Mandel decried the shabby treatment he received.

“The school board was in total violation of their own rules and of the First Amendment to the U.S. Constitution,” Mandel said in the interview. “They should be ashamed of themselves.”

Watch video of Mandel at the school board meeting below.

 

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