Minority Older Adults Research Articles

Measurement Invariance of Screening Measures of Anxiety, Depression, and Level of Functioning in a US Sample of Minority Older Adults Assessed in Four Languages.

Population aging in the US and its increase in racial/ethnic diversity has resulted in a growing body of literature aimed at measuring health disparities among minority older adults. Disparities in health outcomes are often evaluated using self-reported measures and, to attend to linguistic diversity, these measures are increasingly being used in languages for which they were not originally developed and validated. However, observed differences in self-reported measures cannot be used to infer disparities in theoretical attributes, such as late-life depression, unless there is evidence that individuals from different groups responded similarly to the measures—a property known as measurement invariance. Using data from the Positive Minds-Strong Bodies randomized controlled trial, which delivered evidence-based mental health and disability prevention services to a racially/ethnically diverse sample of minority older adults, we applied invariance tests to two common measures of anxiety and depression (the GAD-7 and the HSCL-25) and two measures of level of functioning (the Late-Life FDI and the WHODAS 2.0) comparing four different languages: English, Spanish, Mandarin, and Cantonese. We found that these measures were conceptualized similarly across languages. However, at the item-level symptom burden, we identified a non-negligible number of symptoms with some degree of differential item functioning. Spanish speakers reported more worry symptoms and less somatic symptoms for reasons unrelated to their psychological distress. Mandarin speakers reported more feelings of restlessness, and both Mandarin and Cantonese speakers reported no interest in things more often for reasons unrelated to their psychological distress. Mandarin and Cantonese speakers were also found to consistently report more difficulties performing physical activities for reasons unrelated to their level of functioning. In general, invariance tests have been insufficiently applied within psychological research, but they are particularly relevant as a prerequisite to accurately measure health disparities. Our results highlight the importance of conducting invariance testing, as we singled out several items that may require careful examination before considering their use to compare symptoms of psychological distress and level of functioning among ethnically and linguistically diverse older adult populations.

Help-seeking behaviours among older adults: a scoping review protocol

IntroductionDespite evidence that illustrates the unmet healthcare needs of older adults, there is limited research examining their help-seeking behaviour, of which direct intervention can improve patient outcomes. Research in this...

Digital Health Information Disparities in Older Adults: a Mixed Methods Study

Important health information including disease prevention and chronic disease self-management is increasingly packaged for digital use. The purpose of this sequential explanatory mixed methods study was to describe the extent of computer ownership, Internet access, and digital health information use in an ethnically diverse sample of older adults, comparing ownership, access, and use of digital health information (DHI) across ethnic groups and identifying the factors associated with them quantitatively. Significant differences in computer ownership, Internet access, and DHI use were found across ethnic groups (African American, Afro-Caribbean, Hispanic American, and European American). Logistic regression identified older age, less education, lower income, and minority group membership as significant predictors of limited DHI use. Older African Americans were one-fifth as likely to own a computer than were European Americans; Hispanic Americans were one-half as likely to have access to the Internet. We then conducted a series of focus groups which highlighted differences across ethnic groups. Participants in the African American/Afro-Caribbean group expressed frustration with lack of access to DHI but appreciation for alternative sources of information. Hispanic Americans critiqued information received from providers and drug inserts, some suggesting that a positive attitude and trust in God also contributed to getting well. European American participants evaluated various DHI websites, looking to providers for help in applying information to their personal situation. As the development and use of DHI continue, parallel efforts to increase access to DHI among economically disadvantaged and minority older adults are critical to prevent further disfranchisement.

Promising Aging in Community Models in the U.S.: Village, Naturally Occurring Retirement Community (NORC), Cohousing, and University-Based Retirement Community (UBRC).

Aging in Community (AIC) is the preferred way to age. This systematic review identified promising AIC models in the U.S. and analyzed model characteristics and push-pull factors from older adults’ perspectives. Push factors are those driving older adults to leave, while pull factors attract them to stay in a community. We conducted a two-phase search strategy using eight databases. Phase I identified promising AIC models and Phase II expanded each specific model identified. Fifty-two of 244 screened articles met the criteria and were analyzed. We identified four promising AIC models with the potential to achieve person-environment (P-E) fit, including village, naturally occurring retirement community (NORC), cohousing, and university-based retirement community (UBRC). Each has a unique way of helping older adults with their aging needs. Similar and unique push-pull factors of each AIC model were discussed. Analyses showed that pull factors were mostly program factors while push factors were often individual circumstances. Continued research is needed to address the challenges of recruiting minority older adults and those of lower socio-economic status, meeting older adults’ diverse and dynamic needs, and conducting comparative studies to share lessons learned across the globe.

Conscious and Non-Conscious Processes Regulate Minority Older Adults’ Sedentary Behavior

Accumulating evidence suggests that sedentary behavior (SB), or time spent sitting, is regulated by both conscious (e.g., intentions) and non-conscious (e.g., habits) motivational processes. Much of the work investigating these processes has employed summary-based measures of typical motivation and behavior. This study employed ecological momentary assessment (EMA) methods and accelerometry to determine the extent to which conscious and non-conscious processes regulate minority older adults’ momentary decisions to engage in SB. Over the course of the 8-day study, minority older adults (N=91; age range: 60-89 years, 96% Black/African American) answered 6 EMA questionnaires/day on a mobile phone and wore an ActivPAL activity monitor to measure SB. EMA questionnaires assessed momentary intentions to limit SB over the next two hours. SB habit strength was self-reported at an introductory session. Results from a multilevel linear regression model indicated that on occasions when individuals had stronger intentions than usual to limit SB, they subsequently engaged in less SB (b=-3.72, p<0.01). Individuals who had stronger SB habits, tended to engage in more SB (b=3.00, p<0.01). An additional multilevel model revealed that habits did not significantly moderate the association between momentary intentions and subsequent SB (b=-1.06, p=0.09). In conclusion, minority older adults’ momentary SB appears to be directly influenced by both conscious and non-conscious motivational processes, though the interactive effects are unclear. Interventions to reduce minority older adults’ SB should include content to increase intentions to limit SB (e.g., information on instrumental and affective consequences) and disrupt habitual SB (e.g., action planning).

Assessing Functional Need of Minority Older Adults Across Two Long-Term Services and Supports Settings

Research has suggested that growth in Black and Hispanic older adults’ nursing home (NH) use may be the result of disparities in options for long-term services and supports (LTSS). To investigate this issue, we aimed to determine whether there were no differences in the functional needs of racial and ethnic groups who received care in NHs versus the community. We identified respondents aged ≥65 years in the 2016 Health and Retirement Study who reported requiring caregiving help. We compared the site of care for Black and Hispanic older adults (minority group) to White older adults (comparison group). We performed unadjusted analyses to assess the association of functional need with community vs. NH care. Functional need was operationalized using a functional-limitations score and six individual activities of daily living (ADL). There were 186 minority older adults (community=78%, NH=22%) and 357 White older adults (community=50%, NH=50%). Across settings, minority older adults did not differ in age, marital status, and income, but a greater percentage of men were in NHs (48% versus 28%; p=0.01). The functional-limitations score was higher in NHs than in the community for both groups. Functional needs for the minority group were similar across the two settings in 2/6 ADLs (dressing p=0.11, toileting p=0.09), while White older adults in NHs were more impaired in all ADLs. Functional need for minority older adults primarily differed by setting while demographics did not. These are important factors to consider when implementing programs to keep older adults out of NHs and in the community.

Insights Gained From Developing Academic-Community Partnerships for Minority Aging, Community-Engaged Research

Increasingly community-engaged research, characterized by collaborations between researchers and community partners, is recognized as an important part of translating research into improved health outcomes and reduced health disparities for community participants. Training community participants to engage in some or all aspects of this research, particularly focusing on racial and ethnic minority older adults, highlights the need to understand its opportunities and challenges. With this symposium we will discuss and reflect on community-engaged and community-based participatory research approaches to community-academic partnerships with minority older adults. The first presentation addresses recruitment, retention, and training of a community advisory board of older African Americans in Michigan. The second presentation addresses a health education outreach and engagement program to improve health outcomes among older African Americans in California. The third presentation combines community engagement with survey design methods for research with older Native Hawaiian and Pacific Islander adults to improve data collection and health outcomes in this U.S. population. The final presentation examines partnerships between a hospital memory clinic, meal delivery service, research university, and low-income health clinic to improve caregiver and dementia patient outcomes for minority older adults. The symposium discussant will address opportunities, challenges, and implications of community-academic partnerships promoting minority aging.

Time-Varying Associations of Physical Activity on Weekdays and Weekend Days in Minority Older Adults

Older adults are insufficiently physically active, and therefore, are at an increased health risk. However, less is known about the moment-to-moment physical activity behavior patterns that change across the day. The current study utilized accelerometry to better understand diurnal physical activity patterns. Minority older adults (N=91, age M=70.14, 96% Black/African American) participated in an 8-day study where they wore an ActivPAL accelerometer to measure physical activity. Physical activity was operationalized as stepping in the 60-minute window (±30-min) around a given moment. Time varying-effect modeling was used to determine how physical activity patterns change over the course of weekdays and weekend days. Results are rounded to the 5-min interval. On weekdays, time spent stepping increased from 8:00am (B=7.16, 95%CI: 5.04, 9.27) until peaking at 11:10am (B=8.46, 95%CI: 6.59, 10.33), slowly decreased to the lowest point at 6:10pm (B=6.72, 95%CI: 4.82, 8.62), and then increased slightly in the evening. On weekend days, time spent stepping was lowest at 8:00am (B=4.47, 95%CI: 2.14, 6.80), peaked at 12:20pm (B=5.50, 95%CI: 3.22, 7.78), gradually decreased until 5:50pm (B=5.21, 95%CI: 2.90, 7.52), and then increased slightly in the evening. Minority older adults engage in more stepping time around mid-day, but less stepping in the late afternoon to early evening on both weekdays and weekend days. Self-care activities (e.g., mealtime, bed-time routines) may influence older adults’ physical activity. This work identifies vulnerable times during the day when older adults engage in relatively low levels of physical activity which may be of interest for interventions.

Health Among Sexual Minority Older Adults: Individual Differences and Implications for Improving Health

The number of sexual minority (SM) older adults is increasing rapidly, yet this population continues to be underrepresented in research (Fredriksen-Goldsen & Kim, 2017) and experiences significant disparities in health and health care access (Fredriksen-Goldsen, 2016; Wallace et al., 2011). In the current symposium, we analyze data from U.S. national probability samples of middle-aged and older adults (MIDUS, HRS, NESARC-III) to consider how age-related concerns and challenges may be experienced differently by SM individuals compared to their heterosexual counterparts. This symposium includes novel methods and statistical tools, such as daily diary assessments, multilevel modeling, and time-varying effects models. Individual presentations evaluate how: (1) SM women, compared to heterosexual women, may respond differently to menopause through norms and values surrounding womanhood; (2) midlife and older SM individuals use alcohol and cigarettes more frequently across a typical week than their heterosexual counterparts, though their substance use may not be tied to common triggers (e.g., negative mood, stress); (3) despite bisexual older adults reporting more health problems compared to lesbian and gay counterparts, they are less prepared for health concerns and crises (e.g., reporting a lower number of valid wills); and (4) the prevalence of depression and anxiety varies across age, such that older SM adults—especially women—are particularly vulnerable to psychological health problems. These presentations collectively examine complex issues facing older SM adults while emphasizing individual differences (i.e., women’s concerns, bisexual people’s issues). We discuss challenges in researching this growing at-risk population, and we highlight areas of future research and intervention.

Addressing Racial Compatibility Between Trainees and Minority Older Adults in Applied Care Settings

This talk explores the importance of a racially diverse graduate student interacting in an applied care setting with minority older adults in the Southeast relative to assessment of cognitive status and in the context of cultural mistrust and misdiagnosis. ~250 older adults (16% AA) in an applied care setting were administered a cognitive screener as part of a larger research battery. An independent samples t-test was conducted to assess differences in mean cognitive status. Non-Hispanic Whites (NHW) (M=76.8 years) were found to be more intact than AAs (M=73.27) on measures of cognitive status (21.32 vs. 14.72, t=4.976, p=.0001). Implications highlight that cognitive screeners have often been found to lack sensitivity in groups of marginalized older adults. Having an AA graduate student in these settings could be a way of mitigating the effects of culturally incompatible screening tools and bridging the gap between research and practice for AA older adults.

Hearing Care Disparities in Dementia: Access and Usability in the Coming Era of OTC Hearing Aids

Age-related hearing loss is highly prevalent among persons with dementia (PwDs) and is associated with an increased risk of neuropsychiatric symptoms. However, few use hearing aids and disparities exist. PwDs and, in particular, minority older adults, have some of the lowest rates of hearing aid use. Recent federal legislation created the designation of over-the-counter hearing aids, which will debut by 2020-2021, and represents an opportunity to advance accessibility. This presentation will share estimates of hearing aid use among community-dwelling PwDs from two cohorts, where hearing aid use ranges from 7-11% among African Americans versus 33-45% among whites. To explore this gap, the presentation will share findings from semi-structured interviews with care partners of PwDs and hearing loss around barriers and facilitators of hearing care, including device usability. With growing understanding of sensory health, a changing hearing care landscape represents a critical opening to increase access to hearing care for PwDs. Part of a symposium sponsored by the Alzheimer’s Disease Research Interest Group.

Engaging Older Minority Adults in a Smartphone-Based Ecological Momentary Assessment Study of Sedentary Behavior

Minority older adults engage in excessive levels of sedentary behavior (i.e., sitting). Smartphone-based ecological momentary assessment (EMA) methods can provide novel insights into the modeling and prediction of activity-related behaviors. Yet, minority groups report barriers to participating in mobile health research (e.g., distrust, lack of interest, underrepresentation in research). This abstract reports on strategies used to recruit minority older adults and acceptability of an 8-day smartphone-based sedentary behavior EMA study in this population. Researchers partnered with existing community organizations servicing the target population (i.e., independent living communities, congregate meals sites, and churches) and trusted individuals within these organizations to facilitate introduction of the research team/study. In total, 123 older minority adults were recruited, 102 met inclusion criteria and 91 completed the study. During the study, participants answered 6 electronic EMA questionnaires/day and wore an ActivPAL activity monitor continuously. Participants received one-on-one training on these procedures and received check-in calls to monitor progress. Open-ended questions administered at the end of the study revealed the most enjoyable aspects of the study were the ability to learn more about themselves, contributing to science and/or their community, engaging in a new activity followed by receiving financial compensation and having someone checking on their progress. Least enjoyable aspects of the study included frequency of EMA questionnaires, apprehension of missing EMA questionnaires, carrying the smartphone, and difficulty wearing the activity monitor. Almost all participants (95%) expressed interest being contacted for future studies. Implications for future technology-based research regarding minority older adults’ activity-related behaviors will be discussed.

Sleep Quality Among Older Women and Men in the United States by Sexual Orientation

Sleep problems may increase the risk for, and result from, other health problems and negatively impact quality of life. Lesbian, gay, and bisexual older adults report more sleep problems compared to their straight counterparts when such problems are measured in the aggregate (e.g. “one or more of four specific sleep problems”). However, scant national research has examined if specific types of sleep problems vary by sexual orientation among older adults. Using 2015-2018 National Health Interview Survey (NHIS) data, we used logistic regression to separately model five sleep problems among women 50+ and men 50+ (lesbian/gay women: n=377, bisexual women: n=142, straight women: n=33,216; gay men: n=508, bisexual men: n=115, straight men: n=25,998) as functions of sexual orientation, controlling for age, race, education, and income. Sexual minority older adults were more likely than their straight counterparts to have taken sleep medication in the past week (women AOR=2.04, 95% CI:1.55, 2.67; men AOR=1.81, 95% CI:1.36, 2.40). The only other difference by sexual orientation found for men was bisexual older men’s greater likelihood, compared to straight men, of having difficulty falling asleep (AOR=2.02, 95% CI: 1.08, 3.79). Older women did not differ by sexual orientation in difficulty falling asleep, difficulty staying asleep, or waking up not feeling rested for four or more days in the past week, or meeting National Sleep Foundation recommendations for hours of sleep per night, whether lesbian/gay and bisexual women were examined together or disaggregated. Future research may examine why sleep quality only sometimes varies by sexual orientation.

Cognitive Function in Sexual and Gender Minority Older Adults

Nearly 3.5 million sexual and gender minority (SGM) adults aged 60+ in the U.S. identify as lesbian, gay, bisexual, transgender, and/or queer. We recruited over 50 diverse SGM older adults from the community to better understand correlates of their cognitive function. The Telephone Interview for Cognitive Status, an 11‐item screening test of global cognition was used over the phone or in-person. We will describe relationships among cognition and several sociodemographic and health variables (age, sex assigned at birth, SGM identities, race/ethnicity, and health). Past research has highlighted higher rates of perceived memory problems among lesbian, bisexual and transgender adults compared to both gay men and heterosexual men and women. These rates were also higher among those who identify as women. We highlight implications for researching gender identity and cognition in late life, such as the influence of gender roles on cognition and the assessment of gender expression and related constructs.

Advance Care Plans for Sexual Minority Older Adults: Disparities Across Lesbian, Gay, and Bisexual Individuals

To ensure preference-based care, health providers advise individuals to establish advance care plans (e.g., power of attorney, valid will; NIA, 2018). Though important for all individuals to prepare for declining health, it is critical for bisexual older adults to establish plans given they evidence more health problems compared to heterosexual, lesbian, and gay counterparts (Fredriksen-Goldsen et al., 2016). To assess factors related to having advance care plans, we used data from sexual minority older adults (n=158) in the Health and Retirement Study (2016). Bisexual individuals reported a lower number of valid wills than lesbian and gay participants, t(152)=3.80, p<.001. This finding is particularly alarming given bisexual people are the numeric majority of sexual minorities and experience elevated health problems in older age. We will discuss mechanisms of disparities, the need for research on end-of-life care for sexual minorities, and implications for improving healthcare providers role in facilitating care plans.

Engaging rural older minority adults in dementia research during a pandemic‐associated quarantine

BackgroundRural‐dwelling individuals are at heightened risk for dementia syndromes as they age. Recognizing that faith institutions are bulwarks in rural communities, we partnered with churches to design research that aims to improve knowledge of, and promote screening for, dementia. Since recruitment began just as COVID‐19 emerged, in‐person recruitment ceased. We developed a virtual protocol to train health educators and engage rural, racially diverse congregants.MethodGuided by Schoenberg’s (2011) “Faith Moves Mountains” model, health educators were trained via videoconferencing, using Alzheimer’s Association online English/Spanish resources. Educators approached 35 congregants to administer telephone‐based teaching, pre‐post tests of dementia knowledge, and dementia screening.ResultsThirty rural older adults responded to faith health educator tele‐recruitment and intervention. Pre‐post knowledge surveys showed significant improvement (r=.67, p=.04). Thirteen (43%) completed dementia screening, followed by referral to a memory telehealth clinic.ConclusionThis faith‐based model shows promise for reaching isolated rural residents facing dementia risk.

Influenza Vaccination among Underserved African-American Older Adults.

Background Racial disparities in influenza vaccination among underserved minority older adults are a public health problem. Understanding the factors that impact influenza vaccination behaviors among underserved older African-Americans could lead to more effective communication and delivery strategies. Aims We aimed to investigate rate and factors associated with seasonal influenza vaccination among underserved African-American older adults. We were particularly interested in the roles of demographic factors, socioeconomic status, and continuity and patient satisfaction with medical care, as well as physical and mental health status. Methods This community-based cross-sectional study recruited 620 African-American older adults residing in South Los Angeles, one of the most under-resources areas within Los Angeles County, with a population of over one million. Bivariate and multiple regression analyses were performed to document independent correlates of influenza vaccination. Results One out of three underserved African-American older adults aged 65 years and older residing in South Los Angeles had never been vaccinated against the influenza. Only 49% of participants reported being vaccinated within the 12 months prior to the interview. One out of five participants admitted that their health care provider recommended influenza vaccination. However, only 45% followed their provider's recommendations. Multivariate logistic regression shows that old-old (≥75 years), participants who lived alone, those with a lower level of continuity of care and satisfaction with the accessibility, availability, and quality of care, and participants with a higher number of depression symptoms were less likely to be vaccinated. As expected, participants who indicated that their physician had advised them to obtain a flu vaccination were more likely to be vaccinated. Our data shows that only gender was associated with self-report of being advised to have a flu shot. Discussion. One of the most striking aspects of this study is that no association between influenza vaccination and being diagnosed with chronic obstructive pulmonary disease or other major chronic condition was detected. Our study confirmed that both continuity of care and satisfaction with access, availability, and quality of medical care are strongly associated with current influenza vaccinations. We documented that participants with a higher number of depression symptoms were less likely to be vaccinated. Conclusion These findings highlight the role that culturally acceptable and accessible usual source of care van play as a gatekeeper to facilitate and implement flu vaccination among underserved minority older adults. Consistent disparities in influenza vaccine uptake among underserved African-American older adults, coupled with a disproportionate burden of chronic diseases, places them at high risk for undesired outcomes associated with influenza. As depression is more chronic/disabling and is less likely to be treated in African-Americans, there is a need to screen and treat depression as a strategy to enhance preventive care management such as vaccination of underserved African-American older adults. Quantification of associations between lower vaccine uptake and both depression symptoms as well as living alone should enable health professionals target underserved African-American older adults who are isolated and suffer from depression to reduce vaccine-related inequalities.

Influence of Nursing Care on Perceptions of Care Coordination in Older Minority Adults with Treated with Radiation Therapy for Advanced or Recurrent Cancer

To describe the influence of nursing care on the perception of care coordination of ethnically diverse older adults with advanced or recurrent cancer treated with radiation therapy at an urban academic center. Despite the increasing number of older mostly minority adults living with advanced cancer in poorly resourced urban communities, there is a lack of research that describes the patient’s perception of the impact of nurses on care coordination and participation in the healthcare team. Qualitative component of an Institutional Review Board approved mixed methods study that involved semi structured interviews conducted to discuss perceptions of coordination of care, distress and supportive care needs. The participants included 31 community dwelling adults (≥ age 60), who received radiation therapy at an urban academic medical center. All interviews were audio-taped, and then transcribed by a HIPAA compliant transcription service. The transcripts were entered into computer software to facilitate coding and analysis. Of the 31 participants who completed the interviews, 20(64.5%) men and 11 women (38%). The mean age for both men and women was 70. Participants had a variety of cancers; the most prevalent were prostate (32%), head and neck (29%) and breast (10%) and 45% were actively receiving treatment. The race/ethnic groups were represented with African Americans, 35%, Caucasian and Hispanic were 19% and Mixed/other 6%. The themes revealed showed that most participants perceptions were nurses were not viewed as part of the healthcare team and care coordination was viewed as a relationship between the patient and the healthcare team with the patient viewed as an integral part of the team. The nurse was not routinely perceived as part of the healthcare team therefore did not influence care coordination. The themes identified were based on the participants’ perceptions of the healthcare team, evidence of coordination of care and sources of personal strength. We found that older adults are aware of the concept of coordination of care and believe their care is coordinated successfully. Despite daily interactions with patients receiving radiation therapy most patients do not acknowledge the impact of nurses on care coordination and are not able to articulate the role of nurses as members of the healthcare team. Additional research is needed to explore and improve patient perception of the nurse’s role in the coordination of care.

Elevated Risk of Cognitive Impairment Among Older Sexual Minorities: Do Health Conditions, Health Behaviors, and Social Connections Matter?

Little research has examined cognitive health disparities between sexual minority and heterosexual populations. Further, most extant studies rely on subjective measures of cognitive functioning and non-probability samples. This study uses a performance-based cognitive screening tool and a nationally representative sample of older Americans to examine the disparity in cognitive impairment by sexual orientation and the potential mechanisms producing this disparity. Using data from the 2015-2016 National Social Life, Health, and Aging Project (N = 3,567), we analyzed respondents' scores on the survey-adapted Montreal Cognitive Assessment. We estimated ordinal logit regressions to examine the relationship between sexual orientation and cognitive impairment and used the Karlson-Holm-Breen method to assess how mental and physical conditions, health behaviors, and social connections mediate this relationship. The prevalence of cognitive impairment is significantly higher among sexual minority older adults than among heterosexual older adults when sociodemographic factors are adjusted for. Depressive symptoms explain some of this prevalence gap. Although anxiety symptoms, physical comorbidity, health behaviors, and social connections may contribute to cognitive impairment, they do not explain the cognitive disparity by sexual orientation. The findings indicate that depressive symptoms are an important link between minority sexual orientation and cognitive impairment and highlight the importance of studying other potential mechanisms that we could not explore in this study. Future research should further investigate how minority stress processes may unfold to accelerate cognitive decline among sexual minorities over the life course.

The Aging Experiences of LGBTQ Ethnic Minority Older Adults: A Systematic Review.

In gerontological research and practice, an increasing amount of attention is being paid to lesbian, gay, bisexual, transgender, and queer (LGBTQ) older people and how their experiences differ from their heterosexual and cisgender counterparts. However, LGBTQ older adults themselves are not a homogenous group. Moreover, as the immigrant populations in industrialized nations age, the number of LGBTQ older adults from ethnic minority backgrounds will only grow. This systematic review hence investigates the experiences of LGBTQ ethnic minority older adults. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, we conducted a systematic search in 5 databases for English peer-reviewed studies. The retrieved articles were coded and analyzed inductively using an intersectional framework to tease out the varying influences of ethnicity, age, gender, and sexual identity on the LGBTQ ethnic minority older adults' experiences. A total of 30 articles across 21 studies (13 qualitative, 7 quantitative, and 1 mixed-methods) were identified. Six key themes emerged from the studies: stigma and discrimination; isolation, support and belonging; interactions with services and institutions; self-acceptance, resilience, and agency; mental health and well-being; and uncertain futures. The experiences of LGBTQ ethnic minority older adults echo those of LGBTQ ethnic majority older adults when they are shaped by gender and sexual identity factors. Nevertheless, significant differences in experiences-both positive and negative-emerge when cultural and ethnicity-related factors come to the fore. These findings emphasize the need for intersectional aging policies and services that go beyond catering for LGBTQ older adults to include the diversity within this subpopulation.