Health‐Related Quality of Life Among Sexual and Gender Minority Older Adults Living With Cognitive Impairment

Abstract

AbstractBackgroundWhile sexual and gender minority (SGM) older adults are found to be at heightened risks of cognitive impairment, they may face unique challenges in health‐related quality of life (HRQOL) due to bias, social isolation, and other SGM‐related risks. This study examined risk and protective factors predicting HRQOL among SGM older adults living with cognitive impairment.MethodA subset of longitudinal survey data collected over three time points (2014, 2016, 2018) was drawn from the Aging with Pride: National Health, Aging, and Sexuality/Gender Study. Participants were 855 people who were born in 1964 or earlier and self‐reported having cognitive impairment at Wave 1 (2014). We employed multilevel modeling to investigate the effects of risk and protective factors on the overall levels of physical and psychological HRQOL and their longitudinal changes.ResultLifetime SGM‐related discrimination and victimization (b = ‐0.17, p < .001; b = ‐0.22, p < .001, respectively), identity stigma (b = ‐0.91, p < .05; b = ‐2.97, p < .001), and insufficient food intake (b = ‐2.70, p < .001; b = ‐3.69, p < .001) were associated with lower physical and psychological HRQOL. Having more chronic conditions (b = ‐1.52, p < .001) was associated with lower physical HRQOL. Factors positively associated with physical and psychological HRQOL were physical activity (b = 0.12, p < .01; b = 0.19, p < .001), outdoor leisure activity (b = 3.57, p < .001; b = 5.40, p < .001), optimal sleep (b = 3.47, p < .001; b = 2.32, p < .001), and social network size (b = 0.19, p < .01; b = 0.66, p < .001).ConclusionThe results of this study have important implications for further research. Most research on cognitive impairment has previously adopted a disease and deficit‐focused model rather than investigating the resilience and quality of life of people living with cognitive impairment. It is critical to further identify ways to help SGM older adults with cognitive impairment adhere to health‐promoting behaviors and to foster and maintain social resources as we develop targeted and culturally responsive interventions that support their optimal aging.